The Modified Bohlman Method for Pediatric High-Grade Spondylolisthesis: Greater than 2-year Follow-up Data From a...

Area of Science:

• Spine surgery
• Pediatric orthopedics
• Spinal fusion techniques

Background:

• High-grade spondylolisthesis (HGS) presents significant challenges in pediatric spinal deformity.
• The modified Bohlman method (mBm) combines an allograft strut, bone screws, and posterior lateral fusion for HGS treatment.
• Assessing the efficacy of mBm in pediatric HGS is crucial for surgical decision-making.

Purpose of the Study:

• To evaluate the clinical, radiographic, and patient-reported outcomes of the modified Bohlman method (mBm) in pediatric patients with high-grade spondylolisthesis (HGS).
• To determine the safety, effectiveness, and cost-effectiveness of the mBm technique for achieving spinal arthrodesis in HGS.

Main Methods:

• Retrospective review of seven pediatric patients (under 18) with HGS (Meyerding grade ≥3) treated with mBm between 2009-2022.
• Analysis of pre- and post-operative radiographic spinopelvic parameters and fusion rates (Brantigan-Steffee criteria).
• Collection of clinical outcomes, complications, Oswestry Disability Index (ODI), and Scoliosis Research Society-22r (SRS-22r) scores at minimum 2-year follow-up.

Main Results:

• All seven patients achieved solid radiographic fusion at L5-S1 with a mean follow-up of 4.7 years.
• Significant improvements observed in slip angle, lumbosacral angle, and sacral slope post-surgery.
• Excellent long-term functional outcomes reported, with a median ODI of 3.5% and mean SRS-22r of 4.4. No revision surgeries were needed.

Conclusions:

• The modified Bohlman method (mBm) demonstrates reliable fusion rates and favorable spinopelvic alignment in pediatric HGS.
• mBm offers a cost-effective solution with low disability rates, supporting its use in selected pediatric HGS cases.
• This technique provides a safe and effective treatment option for achieving stable arthrodesis in pediatric high-grade spondylolisthesis.