{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T08:07:28Z","timestamp":1771488448781,"version":"3.50.1"},"reference-count":40,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["SPI"],"published-print":{"date-parts":[[2014,5]]},"abstract":"<jats:sec>\n<jats:title>Object<\/jats:title>\n<jats:p>The ideal surgical management of high-grade spondylolisthesis remains unclear. Concerns regarding the original Bohlman transsacral interbody fusion technique with stand-alone autologous fibular strut include late graft fracture and incomplete reduction of lumbosacral kyphosis. The authors' goal was to evaluate the radiographic and surgical outcomes of patients treated for high-grade spondylolisthesis with either transsacral S-1 screws or standard pedicle screw fixation augmenting the Bohlman posterior transsacral interbody fusion technique.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>A retrospective review of patients who underwent fusion for high-grade spondylolisthesis in which a Bohlman oblique posterior interbody fusion augmented with either transsacral or standard pedicle screw fixation was performed by 4 spine surgeons was completed. Estimated blood loss, operating time, perioperative complications, and need for revision surgery were evaluated. Upright pre- and postsurgical lumbar spine radiographs were compared for slip percent and slip angle.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>Sixteen patients (12 female and 4 male) with an average age of 29 years (range 9\u201366 years) were evaluated. The average clinical follow-up was 78 months (range 5\u2013137 months) and the average radiographic follow-up was 48 months (range 5\u2013108 months). Ten L4\u2013S1 and 6 L5\u2013S1 fusions were performed. Five fibular struts and 11 titanium mesh cages were used for interbody fusion. Six patients had isolated transsacral screws placed, with 2 (33%) of the 6 requiring revision surgery for nonunion. No nonunions were observed in patients undergoing spanning pedicle screw fixation augmenting the interbody graft. Six patients experienced perioperative complications including 3 iliac crest site infections, 1 L-5 radiculopathy without motor involvement, 1 deep vein thrombosis, and 1 epidural hematoma requiring irrigation and debridement. The average estimated blood loss and operating times were 763 ml and 360 minutes, respectively. Slip percent improved from an average of 62% to 37% (n = 16; p &lt; 0.01) and slip angle improved from an average of 18\u00b0 to 8\u00b0 (n = 16; p &lt; 0.01). No patient experienced L-5 or other motor deficit postoperatively.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>The modified Bohlman technique for treatment of high-grade spondylolisthesis has reproducible outcomes among multiple surgeons and results in significant improvements in slip percent and slip angle. Fusion rates were high (14 of 16; 88%), especially with spanning instrumentation augmenting the oblique interbody fusion. Rates of L-5 motor deficit were low in comparison with techniques involving reduction of the anterolisthesis.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2014.1.spine12904","type":"journal-article","created":{"date-parts":[[2014,2,21]],"date-time":"2014-02-21T16:08:28Z","timestamp":1392998908000},"page":"523-530","source":"Crossref","is-referenced-by-count":40,"title":["High-grade spondylolisthesis treated using a modified Bohlman technique: results among multiple surgeons"],"prefix":"10.3171","volume":"20","author":[{"given":"Robert A.","family":"Hart","sequence":"first","affiliation":[{"name":"1Orthopaedic Surgery, Oregon Health & Science University, Portland;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher M.","family":"Domes","sequence":"additional","affiliation":[{"name":"2Orthopaedic Surgery, University of Washington, Seattle, 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