79 year old male with extensive cardiac history who underwent several previous surgeries, initially for degenerative disease and subsequent complex deformity correction with a pedicle subtraction osteotomy (PSO).
Patient developed failure at the top of his fusion with screw pullout, kyphotic deformity, and broken distal rods with incomplete spinal fusion.
Complaining of pain in the mid back with cracking and popping when he moved.
Stands with a forward and right leaning posture.
Underwent removal of instrumentation, Smith-Petersen osteotomies (SPO), and extension of instrumented fusion to the upper thoracic spine.
Post-operative x-rays show restoration of sagittal balance with the head directly over the femoral heads.