Abstract
We present the case of a 63-year-old woman with a history of spinal instrumentation for adolescent idiopathic scoliosis who sustained an L1 vertebral body fracture after a fall. The patient exhibited sagittal imbalance and flatback deformity, with significant anatomical distortion from prior surgeries. A posterior thoracolumbar transpedicular instrumentation from T12 to L3 was performed using the 7D Flash™ Navigation System (SeaSpine, Carlsbad, CA, USA). Image-guided navigation allowed for accurate screw placement despite complex anatomy, without requiring intraoperative CT. This case highlights the value of spinal navigation in revision settings, particularly for enhancing safety, reducing radiation exposure, and optimizing outcomes in patients with prior instrumentation.