Posterior iliac osteotomy for fixed pelvic obliquity.

In nine children with a myelomeningocele and fixed pelvic obliquity due to uncorrectable lumbosacral scoliosis, a bilateral posterior iliac osteotomy was done and a wedge of bone was transferred form the low side to the high side of the pelvis. This produced a mean correction of 14 degrees (41 per cent) of the pelvic obliquity and a mean correction of the trunk list from the midline of seven centimeters (69 per cent). Two to seven-year follow-ups showed that the correction was permanent, without tendency for the obliquity to return as long as the scoliosis did not progress. The procedure resulted in several complications, including fracture of the pelvis and transient sciatic-nerve palsy; however, it provided a means of correcting pelvic obliquity that could not be corrected by standard procedures.