Case Details Date 10 Oct 2018 Doctor/Team Name Munish C. Gupta, M.D. Skills Smith-Petersen osteotomies Category Adult, Osteotomy, Spinal Deformity Case Information 65 year old female with previous lumbar laminectomies. Very bad low back pain, only able to walk 20 feet, pain shooting down both legs. Severe Thoracolumbar kyphosis on x-rays, no overall lumbar lordosis, positive sagittal alignment. A same day combined anterior and posterior approach was required to correct this rigid deformity. The T11-L5 discs were removed through anterior approach. A femoral ring from a tissue bank was placed at L3/4 and L4/5, bone chips were placed at the other levels. The patient was then placed prone and Smith-Petersen osteotomies (SPO) were performed from T10-L5, and posterior fusion was from T4 to the pelvis with rods and screws. Post operatively, the thoracolumbar junction kyphosis was corrected and clinical photographs show improved sagittal posture.