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In this article, the authors describe a patient with severe sagittal imbalance despite multiple prior anterior and posterior reconstructive surgeries in which a sacral PSO was performed with good results. A description of this technique as well as a brief review of the literature is provided.<\/jats:p>","DOI":"10.3171\/2017.8.spine17550","type":"journal-article","created":{"date-parts":[[2018,2,9]],"date-time":"2018-02-09T15:02:46Z","timestamp":1518188566000},"page":"532-535","source":"Crossref","is-referenced-by-count":11,"title":["Sacral pedicle subtraction osteotomy for an extreme case of positive sagittal balance: case report"],"prefix":"10.3171","volume":"28","author":[{"given":"Ali K.","family":"Ozturk","sequence":"first","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patricia Zadnik","family":"Sullivan","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vincent","family":"Arlet","sequence":"additional","affiliation":[{"name":"Orthopedic Surgery, University of Pennsylvania Health System, Pennsylvania Hospital, Philadelphia, Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1","series-title":"Eur Spine J","doi-asserted-by":"publisher","first-page":"1459","DOI":"10.1007\/s00586-006-0294-6","article-title":"Sagittal balance of the pelvis-spine complex and lumbar degenerative diseases. 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