Mary B. is a 60 year old female who was diagnosed with scoliosis at age 11.  She underwent bracing for 4 years and was left with a 40 degree curve.  She was involved in a car accident at age 18 and her curve progressed to approximately 82 degrees over the next several years.  At age 25 she underwent a posterior spinal fusion and subsequent instrumentation removal 4 years later due to rod breakage.  Over the ensuing years, she noticed progression of her deformity and a feeling of “tipping” forward and to the left as well as increasing back pain.  She underwent a L1 VCR, osteotomies, and revision posterior spinal fusion.