Spinal pedicle subtraction osteotomy for fixed sagittal imbalance patients

Figure 4 Pre- and post-operative clinical photographs (A)/radiographs (B) of a 65-year-old woman, revealing degenerative lumbar kyphosis with global sagittal imbalance. The patient presented with intolerable lower back pain and stooping symptoms. She underwent L4 pedicle subtraction osteotomy with anterior column support, and the plain film obtained at her most recent follow-up examination shows dramatic improvement in global sagittal alignment as well as the lumbar kyphosis (C and D).