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Age, preoperative measurements and flexibility, and perioperative complications did not differ significantly. The simultaneous group showed significantly lower operative time (449 vs. 618min), blood loss (1039 vs. 1906cc), and hospital stay (6.3 vs. 8.5days) (all, p 0.05). Postoperative radiographic correction and maintenance at the final follow-up showed a non-significant trend favoring the simultaneous group. Our simultaneous prone VATSR and PSF technique showed significantly lower operative time, blood loss,