52 year old male with achondroplasia, had laminectomies at multiple levels more than 15 years ago. Over time he has developed worsening kyphosis, pain and inability to stand straight. He underwent a 2 stage surgery. First stage included multilevel revision decompression to address the stenosis, then a pedicle subtraction osteotomy and instrumentation to correct his deformity. Second stage involved anterior lumbar fusion at L4-5 and L5-S1.