To assess and compare coronal alignment correction at 2year follow-up in adult spinal deformity (ASD) patients treated with and without the kickstand rod (KSR) construct. ASD patients who underwent posterior spinal fusion at a single-center with a preoperative coronal vertical axis (CVA) ≥ 3cm and a minimum of 2year clinical and radiographic follow-up were identified. Patients were divided into two groups: those treated with a KSR and those who were not. Patients were propensity score-matched (PSM) controlling for preoperative CVA and instrumented levels to limit potential biases that my influence the magnitude of coronal correction. One hundred sixteen patients were identified (KSR = 42, Control = 74). There were no statistically significant differences in patient characteristics (p > 0.05). At baseline, the control group presented with a greater LS curve (29.0 ± 19.6 vs. 21.5 ± 10.8, p = 0.0191) while the KSR group presented with a greater CVA (6.3 ± 3.6 vs. 4.5 ± 1.8, p = 0.0036). After 40 PSM pairs were generated, there were no statistically significant differences in baseline patient and radiographic characteristics. Within the matched cohorts, the KSR group demonstrated greater CVA correction at 1year (4.7 ± 2.4cm vs. 2.9 ± 2.2cm, p = 0.0012) and 2year follow-up (4.7 ± 2.6cm vs. 3.1 ± 2.6cm, p = 0.0020) resulting in less coronal malalignment one (1.5 ± 1.3cm vs. 2.4 ± 1.6cm, p = 0.0056) and 2year follow-up (1.6 ± 1.0 vs. 2.5 ± 1.5cm, p = 0.0110). No statistically significant differences in PROMs, asymptomatic mechanical complications, reoperations for non-mechanical complications were observed at 2year follow-up. However, the KSR group experienced a lesser rate of mechanical complications requiring reoperations (7.1% vs. 24.3%. OR = 0.15 [0.03-0.72], p = 0.0174). Patients treated with a KSR had a greater amount of coronal realignment at the 2year follow-up time period and reported less mechanical complications requiring reoperation. However, 2year patient-reported outcomes were similar between the two groups.