Fig. 3A–D.

The patient is a 67-year-old man who initially presented to the clinic with severe back and leg pain and limited walking ability. Preoperative sagittal balance, ODI, and VAS back/leg pain were 116 mm, 50%, and 4.7, respectively. The patient was treated with the T10-L5 MIS lateral approach, L5-S1 ALIF, T12L1, L23, L34 anterior longitudinal ligament release with a hyperlordotic cage placed at those levels, and T10-S1 percutaneous pedicle screws. Two-year followup sagittal balance, ODI, and VAS were 34 mm, 2%, and 2, respectively. (A) Preoperative side-view photograph. (B) Postoperative side-view photograph. (C) Preoperative lateral radiograph. (D) Two-year followup lateral radiograph.