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Research ArticleLumbar Spine

Use of a Reverse Bohlman Technique for Low-Grade Spondylolisthesis

MARTIN H. PHAM, IAN A. BUCHANAN, COURTNEY S. LEWIS, VANCE FREDRICKSON, ALEXANDRA KAMMEN, JOSHUA BAKHSHESHIAN and FRANK L. ACOSTA
International Journal of Spine Surgery October 2019, 13 (5) 486-491; DOI: https://doi.org/10.14444/6065
MARTIN H. PHAM
Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California
MD
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IAN A. BUCHANAN
Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California
MD
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COURTNEY S. LEWIS
Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California
BS
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VANCE FREDRICKSON
Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California
MD
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ALEXANDRA KAMMEN
Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California
BA
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JOSHUA BAKHSHESHIAN
Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California
MD
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FRANK L. ACOSTA JR
Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California
MD
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    Figure 1

    Preoperative anteroposterior and lateral standing radiographs obtained in a 54-year-old man with low-grade spondylolisthesis. Spinopelvic parameters were as follows: 73° sacral slope, 82° lumbar lordosis, 12° pelvic tilt, and 94°pelvic incidence.

  • Figure 2
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    Figure 2

    Axial and sagittal magnetic resonance imaging showing the L5–S1 Grade 2 spondylolisthesis with associated bilateral foraminal stenosis.

  • Figure 3
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    Figure 3

    Schematic of reverse Bohlman approach for transvertebral transsacral cage placement in treatment of low-grade spondylolisthesis. (a) Creation of a tract across the L5 and S1 vertebral bodies. (b) Sequential dilation of tract using a series of drills and reamers. (c) Transvertebral transsacral cage placement.

  • Figure 4
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    Figure 4

    Intraoperative lateral radiographs demonstrating transvertebral transacral cage placement. (a) Creation of guide tract across L5 and S1 vertebral bodies, (b) dilation of tract using a series of drills and reamers, (c) initial cage placement, and (d) cage in final position.

  • Figure 5
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    Figure 5

    Postoperative standing anterior-posterior and lateral x-ray showing the L4-ilium construct with an L5–S1 reverse Bohlman placement of the transvertebral transsacral titanium mesh cage.

  • Figure 6
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    Figure 6

    Postoperative computed tomography showing placement of the L5–S1 transvertebral transsacral titanium mesh cage.

  • Figure 7
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    Figure 7

    Three-year follow-up anterior-posterior and lateral standing films showing maintenance of his overall global alignment without any evidence of instrumentation failure.

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International Journal of Spine Surgery
Vol. 13, Issue 5
1 Oct 2019
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Use of a Reverse Bohlman Technique for Low-Grade Spondylolisthesis
MARTIN H. PHAM, IAN A. BUCHANAN, COURTNEY S. LEWIS, VANCE FREDRICKSON, ALEXANDRA KAMMEN, JOSHUA BAKHSHESHIAN, FRANK L. ACOSTA
International Journal of Spine Surgery Oct 2019, 13 (5) 486-491; DOI: 10.14444/6065

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Use of a Reverse Bohlman Technique for Low-Grade Spondylolisthesis
MARTIN H. PHAM, IAN A. BUCHANAN, COURTNEY S. LEWIS, VANCE FREDRICKSON, ALEXANDRA KAMMEN, JOSHUA BAKHSHESHIAN, FRANK L. ACOSTA
International Journal of Spine Surgery Oct 2019, 13 (5) 486-491; DOI: 10.14444/6065
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Keywords

  • spondylolisthesis
  • lumbar fusion
  • transsacral cage placement
  • Bohlman technique

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