"Reverse Bohlman" technique for the treatment of high grade spondylolisthesis in an adult population

J Orthop. 2016 Jan 22;13(1):1-9. doi: 10.1016/j.jor.2015.12.004. eCollection 2016 Mar.

Abstract

Background/aims: Surgical techniques for effective high-grade spondylolisthesis (HGS) remain controversial. This study aims to evaluate radiographic/clinical outcomes in HGS patients treated using modified "Reverse Bohlman" (RB) technique.

Methods: Review of consecutive HGS patients undergoing RB at a single university-center from 2006 to 2013. Clinical, surgical, radiographic parameters collected.

Results: Six patients identified: five with L5-S1 HGS with L4-L5 instability and one had an L4-5 isthmic spondylolisthesis and grade 1 L5-S1 isthmic spondylolisthesis. Two interbody graft failures and one L5-S1 pseudoarthrosis. Postoperative improvement of anterolisthesis (62.3% vs. 49.6%, p = 0.003), slip angle (10 vs. 5°, p = 0.005), and lumbar lordosis (49 vs. 57.5°, p = 0.049).

Conclusions: RB technique for HGS recommended when addressing adjacent level instability/slip.

Keywords: High grade spondylolisthesis; Outcomes; Reverse Bohlman.