Orthopaedic Spine Center
450 Broadway St. | MC6342
Redwood City, CA 94063
For Adult Patients: (650) 725-5905

Patient Case Study #4: Coronal and Sagittal Deformity


73 year-old woman who previously had multiple front and back surgeries on her spine by several other surgeons, who presented after feeling a "pop" in her back. She complained of being pitched forward and to the left.


Neurologically normal, but she had significant positive sagittal balance (flexed forward) and coronal imbalance (bent to the left) which could not be actively corrected by the patient.


Two before treatment x-rays show a view from the side and back of the patient demonstrating broken implants and significant 14cm of forward balance, and 6cm of balance to the left (both normally zero). 

Above: X-rays show a view from the side and back of the patient demonstrating broken implants.


Failure of fusion from previous surgeries with broken implants and recurrence of spinal deformity and imbalance.

Selected Treatment

Patient underwent 2-stage procedure with removal of broken implants, replacement of instrumentation, and second-stage asymmetric pedicle subtraction osteotomy which required cutting through the entire spine in two planes, allowing careful realignment of the spine.

Above: X-rays show the revision surgery performed by Dr. Cheng at 2 years.


Patient is now 2 years after surgery by Dr. Cheng.  She has excellent alignment of her spine, is pain-free, and is grateful for giving her “the gift of mobility and my life back.”