In patients with Bertolotti syndrome, the researchers sought to determine how their quality of life (QOL) and patient satisfaction changed after surgical removal of the LSTV pseudo articulation. Over 10 years, an ambidirectional observational cohort study of patients examined at a single institution’s tertiary spine center was conducted. The Bertolotti Syndrome Cohort included 31 patients who received surgical excision of the pseudo articulation. Mental and physical health T-scores preoperatively and postoperatively, as well as a single-item postoperative satisfaction questionnaire from the Patient-Reported Outcomes Measurement Information System Global Health (PROMIS-GH). Diagnostic and procedural codes were used to identify patients. Preoperative PROMIS-GH scores were collected retrospectively from the chart, and postoperative PROMIS-GH and satisfaction scores were collected prospectively via a mail-in survey. PROMIS-GH Physical Health T-score improvement was 8.7 (10.5) on average (SD) (P<0.001). PROMIS-GH Mental Health T-scores improved by 5.9 (9.2) on average (SD) (P=0.001). There were significant group differences in mean change for Physical Health T-scores (P<0.001) and Mental Health T-scores (P=0.009) when PROMIS-GH T-scores were stratified by the answer to the patient satisfaction survey. The PROMIS-GH T-scores improved significantly more in patients who said, “The treatment met my expectations.” As measured by PROMIS-GH Mental and Physical Health, the pseudo articulation resection operation results in considerable increases in quality of life.