55 year old female who had 2 back surgeries elsewhere in 2003. She had developed severe low back pain since and could not stand straight due to worsening deformity. She walked leaning forward and could not maintain an upright posture. She underwent a two stage surgery. First stage involved pedicle subtraction osteotomy and deformity correction and fusion from T3 to Pelvis. During the 2nd stage, anterior lumbar fusion was performed at L5-S1.