Fig. 4

A 46-year old female patient. a, b, c The preoperative X-ray and 3-D CT reconstruction showed that the parietal vertebrae were located at T11/T12, which belonged to the lumbar kyphosis group. d Smith-Petersen osteotomy was conducted at L1–L2, L4–L5, and L5–S1, together with single-segment pedicle subtraction osteotomy (PSO) at L3. Lumbar lordosis, global kyphosis, and sagittal vertical axis improved from the preoperative 44°, 105°, and 257.39 mm to –44°, 53° and 55.47 mm, respectively. e) One-year post-operation, lumbar lordosis, global kyphosis, and sagittal vertical axis were –45°, 60°, and 47.53 mm, respectively. f) At the last follow-up at the 37th-month post-operation, no apparent orthopedic loss was observed, and lumbar lordosis, global kyphosis, and sagittal vertical axis were –47°, 61°, and 48.56 mm, respectively