The patient, Mr. Yang, 49 years old, was admitted to the hospital with “spinal stiffness and humping for more than 20 years”. He was diagnosed with “ankylosing spondylitis” and had poor results in treatment. The patient then developed a hunchback deformity, which gradually worsened, accompanied by chest tightness and several times “pneumothorax”, and could not palpate the abdomen. He was admitted to the hospital for further treatment. On physical examination, the cervical spine was partially restricted, the thoracolumbar spine was stiff and posteriorly convex, the eyes could not see horizontally, the line between the mandible and the brow arch was about 45° from the vertical line in the neutral position of the cervical spine, the muscle strength, muscle tone and skin sensation of the limbs were normal, and the X-ray showed that the thoracolumbar spine was posteriorly convex with a Cobb angle of 120°. After admission, our medical team made a detailed and thorough preoperative plan. On April 18, 2011, the patient underwent a posterior spinal osteotomy with internal fixation for kyphosis. During the operation, the patient was seen to have a significant thoracolumbar kyphosis with bony fusion of the spine in all segments and unclear structure. The lumbar 3 vertebrae were successfully osteotomized to correct the deformity, and the pedicle nails were placed on both sides of thoracic 11, 12, and lumbar 2, 4, and 5 to fix the deformity. The operation lasted 6 hours and was successful. The incision was removed and the patient is scheduled to be discharged recently. The patient was able to see horizontally with both eyes after surgery, and the Cobb angle of thoracolumbar lordosis was corrected from 120° before surgery to 80° after surgery.