Robotic-assisted Bohlman's technique using SI-LOK implants for high-grade L5-S1 Spondylolisthesis: A case series of three patients.

Abstract

High-grade Isthmic Spondylolisthesis often requires surgical intervention for spinal realignment and decompression. This study describes a modified Bohlman procedure utilizing robotic-assisted navigation and a Globus SI-LOK interbody device. A retrospective review was conducted on three patients who underwent the modified Bohlman procedure for high-grade spondylolisthesis at a single hospital between 2022 and 2023. Clinical parameters (age, sex, presenting symptoms, post-operative symptoms), radiographic parameters (lumbar lordosis, pelvic incidence, Wiltse classification), and perioperative data (fusion levels, posterior instrumentation, interbody device, use of DBM, estimated blood loss, complications) were collected. The study included two males and one female, with a mean age of 67 years. Two patients had high-grade L5-S1 Isthmic Spondylolisthesis, and one had grade II L5-S1 Isthmic Spondylolisthesis with L4-L5 degenerative stenosis. All patients presented with low back pain and bilateral lower extremity radiculopathy. The modified procedure involved robotic-assisted placement of pedicle screws and SI-LOK implants. All patients achieved solid L5-S1 fusion without complications or slip progression. The modified Bohlman procedure using robotic-assisted navigation and SI-LOK implants shows promise for managing high-grade isthmic spondylolisthesis, with successful outcomes and no complications in this small cohort.