XXX, male, 48 years old, with a history of ankylosing spondylitis for more than 20 years, in the past 9 years, the curvature of the back has become more and more aggravated, and he can no longer see horizontally, and can only lie on his side when sleeping, with significant back pain, shortness of breath and difficulty in breathing when going up stairs. Due to the severe hunchback, the lower edge of the thorax presses on the abdomen, and the stomach and intestines are pressed, so that he can only eat half a bowl at most once. Examination: Hunchback deformity angle of 70 degrees, compression of thoracic 9 and 10 vertebrae, patient’s cardiopulmonary function was obviously reduced, and the posterior convexity deformity was obvious. After consultation with the Department of Thoracic Surgery, the Department of Anesthesiology and the Department of Respiratory Medicine, a detailed surgical plan was formulated: “posterior transvertebral plate and intervertebral space osteotomy orthopedics, intervertebral bone graft fusion, and internal fixation with pedicle screws”. After the operation, 16 pedicle nails were implanted, and the orthopedic angle reached 40 degrees, and there was no nerve damage after the operation. Comment: In addition to affecting the patient’s appearance, kyphosis also affects the function of other tissues and organs of the human body, affecting cardiopulmonary function and the digestive system, and in severe cases can endanger the patient’s life. Although the risk of surgery for severe kyphosis is high, the effect of surgery is immediate and can significantly improve the patient’s quality of life. Therefore, this type of surgery requires extensive experience in spine surgery, as well as the cooperation of relevant ancillary departments such as anesthesiology.