Case Details Date 22 Apr 2013 Doctor/Team Name Munish C. Gupta, M.D. Skills Pedicle Subtraction Osteotomy Category Adult, Osteotomy, Revision Surgery Case Information This 67-year-old female underwent multiple anterior and posterior fusions with multiple areas of pseudarthrosis and broken instrumentation. The spine fusion did not take and the instrumentation broke. All the instrumentation was removed and the fusion explored. The patient had multiple areas of the spine fusion that were not healed. New instrumentation was then placed. The patient not only had multiple pseudarthrosis (not healed fusion) but also a flatback posture with lack of lumbar lordosis. An asymmetric Pedicle Subtraction Osteotomy (PSO) was performed to recreate the lordosis or swayback and straighten the scoliosis so the patient could stand up straight. Posterior instrumentation was used to correct the deformity and extend the instrumentation to the thoracic spine. The patient can now stand straight and get off the large amount of narcotic medication she was taking before surgery.