Eichler D, et al. - Experts gauged the factors associated with sagittal malalignment recurrence following pedicle subtraction osteotomy (PSO). Full spine radiographs were analyzed in 66 patients (average age 54.5 years, follow-up 3.8 years); follow-up CTs were examined for pseudarthrosis and gas in sacroiliac joints. Findings suggested a possibility of postoperative anterior malalignment recurrence following PSO. Recurrence tended to be seen in elderly patients. Another factor was the loss of lumbar lordosis associated with pseudarthrosis. With malalignment recurrence, anterior trunk rotation and pelvic retroversion might additionally have augmented moments across sacroiliac joints with subsequent ligament laxity and pelvic incidence increase.