After an accident i have a6 prolapsed l4 disc and bilateral bertolotti joints. pain continues for a year with meds n physio. what options do i have?

Several: Bertolotti syndrome is a congenital condition that doesn't usually cause symptoms until adulthood. It can affect the L4-5 disk. When an adequate trial of physical therapy etc. fails, further options include steroid or anesthetic injections, removal of the L4-5 disk and/or resection of the enlarged transverse processes @ the L5 vertebra. Please discuss this with your neurosurgeon.

Bertolotti’s syndrome is intervertebral disc degeneration above the level of a lumbosacral transitional segment. The degeneration often takes the form of a disc herniation and results in spinal canal stenosis and potentially effacement of spinal nerves. The treatment would be to address the disc disease as needed: PT, muscle strengthening, anti-inflammatories, injections, and surgery are options.