Case Details Date 10 Oct 2018 Doctor/Team Name Munish C. Gupta, M.D. Skills pedicle subtraction osteotomy Category Adult, Revision Surgery, Spinal Deformity Case Information 55 year of old with history of multiple previous spine surgeries with increasing back and leg pain and inability to stand upright. Previous instrumentation from C2 to the Pelvis. Leaning forward and to the left. A removal of instrumentation and revision posterior spinal fusion with pedicle subtraction osteotomy (PSO) at L3 was performed. Bone from a tissue bank, the patient’s own bone, and bone morphogenetic protein were used to promote fusion. Post-operative x-rays demonstrate improved sagittal and coronal balance and improved lumbar lordosis.