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

Aria Jamshidi, Allan D. Levi

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Background/aims: Surgical techniques for treatment of high-grade spondylolisthesis (HGS) remain controversial. This study aims to evaluate both radiographic and clinical outcomes in patients with HGS treated with the “modified Bohlman” and Reverse Bohlman technique. Methods: Review of consecutive HGS patients undergoing modified Bohlman and Reverse Bohlman at a single center from 2006 to 2018. Clinical, surgical, and radiographic data were collected. Results: Six patients identified in the modified Bohlman treatment arm: and eight patients in the Reverse Bohlman group. Twelve (12) patients presented with high grade congenital spondylolisthesis at L5-S1; one patient presented with dissolution of the L5 vertebral body secondary to uncontrolled osteomyelitis that developed after a previous failed fusion; and one patient presented with iatrogenic L5-S1 spondylolisthesis after a previous L3-S1 fusion. One patient had medially placement pedicle screw and associated radiculopathy. All follow-up post = operative scans demonstrated solid fusion. Postoperatively, anterolisthesis improved from 18.3% to 10.1% (p = .0586) and the slip angle improved from 60.43° of kyphosis to 48.71° (p = .0139). No spondylolisthesis translational reduction maneuvers were attempted intraoperatively except for positioning on a sacral cushion to increase lordotic angle. Lumbar lordosis improved from 65.29 to 63.86 postoperatively. Four of our fourteen patients had long-term median follow-up of 28 months (range = 19–48 months) slip angle, percentage, and lumbar lordosis all improved from the patient's pre-operative measurements. The improvement in slip angle was nearly statistically significant with a p-value of 0.065. Conclusions: Reverse Bohlman technique for high grade spondylolisthesis is a viable option when seeking to address adjacent level instability or slip.

Original languageEnglish (US)
Pages (from-to)230-236
Number of pages7
JournalJournal of Clinical Neuroscience
StatePublished - Nov 2019


  • Bohlman
  • High grade
  • Reverse
  • Spondylolisthesis

ASJC Scopus subject areas

  • Surgery
  • Neurology
  • Clinical Neurology
  • Physiology (medical)


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