Single-position 360° correction of severe osteoporotic thoracolumbar kyphosis with neurological recovery.

A woman in her seventh decade with severe osteoporosis developed progressive thoracolumbar kyphosis (86°) and new upper motor neuron signs. Imaging revealed vertebral collapse at T11-T12 with partial correction in the prone position. A single-position, prone-only 360° correction was performed using posterior instrumentation and a minimally invasive Extreme Lateral Interbody Fusion (XLIF) corpectomy. Intraoperative navigation and pleural management enabled safe anterior access without repositioning. Postoperatively, kyphosis improved to 24°, neurological function remained intact and mobilisation was achieved with brace support. This case demonstrates the feasibility of single-position correction in complex osteoporotic deformity, highlighting the importance of early recognition and tailored surgical strategy.