**5. Conclusions**

This study demonstrated the clinical and radiological outcomes of combined anterior– posterior procedures via a lateral corpectomy, vertebral reconstruction using an expandable cage with rectangular footplates and posterior percutaneous pedicle screw fixation. The procedure, which includes short segmen<sup>t</sup> fixation, did not improve global spinal alignment and pelvic retroversion. However, the procedure achieved significant reduction of local kyphosis and VAS of back pain. This indicated that the procedure is effective in elderly patients with severe back pain due to spinal deformity and instability caused by OVF despite the global spinal malalignment.

**Author Contributions:** Conceptualization, H.T. (Hidetomi Terai) and H.N.; methodology, H.Y., S.K., T.M. and H.K.; formal analysis, S.T.; data curation, A.M., T.N., M.K., M.H., K.T., H.T. (Hiromitsu Toyoda), and A.S.; writing—original draft preparation, H.T. (Hidetomi Terai); writing—review and editing, H.T. (Hiromitsu Toyoda); supervision, H.N. All authors have read and agreed to the published version of the manuscript.

**Funding:** No funds were received in support of this work.

**Institutional Review Board Statement:** The study was conducted according to the guidelines of the Declaration of Helsinki and approved by the Institutional Review Board of Osaka city university (protocol code 3170 and date of approval 30 June 2015).

**Informed Consent Statement:** The need to obtain informed consent was waived based on the retrospective design and anonymization of patient identifiers.

**Conflicts of Interest:** A.S. received fee for Speakers Bureaus. The other authors declare that they have no conflicts of interest.
