Fig. 1

A, C-arm is gradually rotated until a true PA image of the rotated vertebral body is obtained and both pedicles are mostly symmetrically visualized en face; B, the X-ray of PA view at pre-operation; C, the intraoperative PA image revealed asymmetrical pedicle shadows (red arrows); D, C-arm position is modified and gradually rotated to obtain a true PA image of the rotated vertebral body and both pedicles are nearly symmetrical (red arrows); E and F, the guide wire was at or cross the midline in PA view (E) and reached the anterior one-fourth of the vertebral body at the lateral view (F); G and H, the final intraoperative PA (G) and lateral (H) images; I and J, the PA (I) and lateral (J) X-ray after surgery