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

Background: 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.

Methods: 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.

Results: 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.

Conclusion: 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.