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Revision of the MISDEF algorithm. ACR, anterior column realignment; N, no; PSO, pedicle subtraction osteotomy; Y, yes. a For curved greater than 60, double major curves, consider class III. b For experienced MIS surgeons. (From Choy W, Miller CA, Chan AK, Fu KM, Park P, Mummaneni P V. Evolution of the Minimally Invasive Spinal Deformity Surgery Algorithm: An Evidence-Based Approach to Surgical Strategies for Deformity Correction. Neurosurg Clin N Am 2018;29:399–406; with permission)
