Inclusion Criteria:  >18 years of age at the time of treatment EOS full body or standing 36" AP & Lateral images of entire spine Posterior spine fusion with pedicle screw fixation construct of 5 or more levels Pedicle screw fixation to be supplemented proximally with NuVasive VersaTie system Upper instrumented vertebra (UIV) terminating at a newly instrumented level Lowest instrumented vertebra (LIV) sacrum/pelvis Surgery scheduled to take place in the next 6 months  Exclusion Criteria:  Active spine tumor or infection Deformity due to acute trauma Prisoners Women who are pregnant Patient is unwilling or unable to complete questionnaires