Posterior column osteotomy (PCO) is an approach for treating pediatric patients with a partially flexible, non-focal kyphotic deformity in the setting of an unfused anterior column requiring a modest alignment correction. PCOs can provide up to 10 degrees of correction per level and a harmonious correction can be achieved if performed through multiple levels in appropriately selected patients. Among pediatric patients, the treatment of Scheuermann kyphosis is the most common indication for application of this technique. Although their utility is debated, PCOs can also be effective for assisting in the correction of coronal deformities with partial flexibility, particularly at the apex of thoracic curves [1, 2].