Figure 3. Full-spine radiographs. The anteroposterior view (A) shows an abnormal coronal balance with the patient’s spine deviating to the left of the central sacral vertebral line (the vertical line bisecting the first sacral segment and perpendicular to the iliac crests). The aggressive sacral hemangioma (*) is visible spanning the sacrum, more prominently on the patient’s right side. There is no appreciable scoliotic curvature. The lateral view (B) shows the lumbar lordosis angle (θ) of 7° calculated using a 4-line L1–L5 Cobb method (normal is 20–45°). Thoracic hypokyphosis (flattening) is also evident, while the patient’s C7 plumb line intersected the sacrum, indicating a neutral sagittal balance (measurements not shown). Mild spondylosis is apparent in the lower thoracic and lumbar spine.