Most spinal pathologies can be treated non-surgically, Prof. Koller emphasizes. An important foundation for success is a trained body and musculatur treatment success, weight and nutrition control and strong attitude. However, some pathologies of the spine do need surgical control and correction to relief patient‘s pain and disability and to prevent significant future complications if left untreated. Prof.Koller is known for his dedicated and meticulous surgical case planning, decision making and performing, he stressess that preparation is a key to success. He also emphasizes “that he treats patients and not a radiograph !“. Nevertheless, some images shown here can give an insight into what is possible at the cutting edge in spinal deformity surgery. Each deformity must be assessed individually, and the goal is always a safe surgical result and maintenance of a high functional level for each patient.