Thoracolumbar Kyphosis with Sagittal Imbalance

A 77-year-old patient presented with advanced thoracolumbar kyphosis and significant sagittal imbalance, resulting in difficulty standing upright and marked limitation in daily function.

Her symptoms had progressively impacted mobility, posture, and overall quality of life.

After comprehensive evaluation, a surgical plan was developed to restore alignment and improve functional capacity. The patient underwent complex spinal reconstruction from T9 to the pelvis, including L5–S1 anterior lumbar interbody fusion and an L3 pedicle subtraction osteotomy.

At one-year follow-up, the patient demonstrates restored upright posture with meaningful improvement in pain and function. Objective measures of disability have normalized, and she has regained independence in daily activity.

This case highlights the role of carefully planned deformity correction in restoring alignment, balance, and function—even in advanced presentations.