With the sagittal profile of the spine, conventional thinking has been to categorize it into different segments based on the anatomical differentiation of the vertebrae. This delineation does not take into account the true surface contour of the spine. The disadvantage of this overly simplistic categorization is that when attempting to restore what is perceived as a ‘normal thoracolumbar spine,’ a ‘one size fits all’ approach is used.1

Increased understanding of sagittal plane deformity will lead to earlier identification. As the life expectancy of the population increases along with the patients desire to lead more active lives well into advanced years, so will the demand for appropriate expertise and skill in dealing with this complex problem. Spinal osteotomies remain complicated procedures. This treatment strategy must be the subject of specific training and must be practiced by specialist surgeons for the best outcomes.1

• 1. a. b. Makhni MC, Shillingford JN, Laratta JL, et al. Restoration of Sagittal Balance in Spinal Deformity Surgery. J Korean Neurosurg Soc 2018;61(2):167–179. doi:10.3340/jkns.2017.0404.013.