Two-level reverse Bohlman transsoseous approach for treatment of symptomatic pseudarthrosis.

Journal Article (Journal Article)

Surgical treatment for high-grade spondylolisthesis with high sacral slope remains controversial and no definitive gold standard procedure has been identified. The Bohlman technique, in which a fibular strut is reamed posteriorly across the L5-S1 disc space in an oblique, inferior to superior trajectory, has been increasingly utilized. Recently, a Reverse Bohlman technique has been described, in which a graft is reamed anteriorly across a single disc space in a superior to inferior trajectory. Case Report A 55 year-old male with complete lumbarization of S1 (referred to as L6) and previous L5-L6-S1 posterior instrumented fusion presented, with progressively worsening low back pain and lower extremity radicular pain. After failing conservative management, he underwent a 2-level Reverse Bohlman approach to place a titanium mesh interbody graft (cage) anteriorly from L5 to S1, crossing the L5-6 and L6-S1 disc spaces. Here we describe for the first time a Reverse Bohlman technique spanning two disc spaces in a patient with a transitional lumbosacral anomaly and high sacral slope. At 6 months post-operative follow up, the patient reported near complete resolution of symptoms.

Full Text

Duke Authors

Cited Authors

  • Krause, KL; DeDeaux, C; Jung, E; Than, KD

Published Date

  • February 2019

Published In

Volume / Issue

  • 33 / 1

Start / End Page

  • 84 - 87

PubMed ID

  • 30522354

Electronic International Standard Serial Number (EISSN)

  • 1360-046X

Digital Object Identifier (DOI)

  • 10.1080/02688697.2018.1525481


  • eng

Conference Location

  • England