The London Spine Unit : innovative treatment hospital on Harley Street UK
Published article
BACKGROUND: Circumferential fusion with or without reduction is the preferred treatment for high-grade isthmic spondylolisthesis. Reduction presents significant risk of neurological injury. The authors present one case in which the “reverse Bohlman” technique was used with the addition of a hyperlordotic interbody cage at L4-5 as a means to correct sagittal malalignment while avoiding the reduction of L5 on S1.
Lumbar Decompression Surgery Expert. Best Spinal Surgeon UK
J Neurosurg Case Lessons. 2021 Jun 28;1(26):CASE208. doi: 10.3171/CASE208. eCollection 2021 Jun 28.
ABSTRACT
BACKGROUND: Circumferential fusion with or without reduction is the preferred treatment for high-grade isthmic spondylolisthesis. Reduction presents significant risk of neurological injury. The authors present one case in which the “reverse Bohlman” technique was used with the addition of a hyperlordotic interbody cage at L4-5 as a means to correct sagittal malalignment while avoiding the reduction of L5 on S1.
OBSERVATIONS: The patient was a 22-year-old woman with a long-term history of lower back pain and bilateral L5 radiculopathy secondary to high-grade isthmic lumbar spondylolisthesis. She underwent anterior lumbar interbody fusion using the reverse Bohlman technique plus a hyperlordotic interbody cage at L4-5, followed by decompression and posterior spinal instrumentation and fusion from L4 to the pelvis. At 2-year follow-up, she was found to have complete resolution of symptoms with clinical and radiographic evidence of fusion. Her spinopelvic parameters had significantly improved.
LESSONS: The reverse Bohlman technique with the addition of a hyperlordotic interbody cage at L4-5 is a potential alternative treatment method to correct sagittal malalignment while avoiding possible injury to the L5 nerve roots that can be seen in the reduction of high-grade isthmic spondylolisthesis.
PMID:35854907 | PMC:PMC9245754 | DOI:10.3171/CASE208
The London Spine Unit : innovative treatment hospital on Harley Street UK
Read the original publication: