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  Indian J Med Microbiol
 

Figure 2: Two-level pedicle subtraction osteotomy is performed when single level pedicle subtraction osteotomy cannot restore the physiological sagittal spinal profile. (a) Preoperative thoracic kyphosis was 47°, lumbar lordosis was 14°, sagittal vertical axis was 169 mm, pelvic incidence was 38°, pelvic tilt was 42°, sacral slope was −4°; (b) The simulating L3 single segment pedicle subtraction osteotomy cannot restore sagittal spinal balance; (c) The simulating L1 and L3 two-level pedicle subtraction osteotomy restore sagittal spinal balance: pelvic incidence 38°, lumbar lordosis 42°, pelvic tilt 8.7°, sagittal vertical axis 48 mm

Figure 2: Two-level pedicle subtraction osteotomy is performed when single level pedicle subtraction osteotomy cannot restore the physiological sagittal spinal profile. (a) Preoperative thoracic kyphosis was 47°, lumbar lordosis was 14°, sagittal vertical axis was 169 mm, pelvic incidence was 38°, pelvic tilt was 42°, sacral slope was −4°; (b) The simulating L3 single segment pedicle subtraction osteotomy cannot restore sagittal spinal balance; (c) The simulating L1 and L3 two-level pedicle subtraction osteotomy restore sagittal spinal balance: pelvic incidence 38°, lumbar lordosis 42°, pelvic tilt 8.7°, sagittal vertical axis 48 mm