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Anterior Lumbar Interbody Fusion (ALIF) and Posterior Spinal Fusion (PSF) play pivotal roles in restoring lumbar lordosis in spinal surgery. Debates persist between combined single-position surgery and traditional prone-position PSF for optimizing segmental lumbar lordosis. The study investigates the impact of performing ALIF in the supine position followed by PSF in the prone position on segmental lumbar lordosis. A cohort of 59 patients underwent ALIF and PSF at a single institution. Preoperative, post-ALIF supine, and post-PSF prone Cobb angles were assessed using x-ray imaging. Statistical analyses, including one-way repeated measures ANOVA and Post-hoc analyses with Bonferroni adjustment, were employed for mean comparisons within subjects. The mean Cobb angle for the entire cohort showed significant variations over different time points (p).