The 'MW' sacropelvic construct: an enhanced fixation of the lumbosacral junction in neuromuscular pelvic obliquity

Fixation to the lumbosacral spine to correct pelvic obliquity in neuromuscu lar scoliosis has always remained a surgical challenge. The strongest fixat ion of the lumbosacral junction has been achieved with either a Galveston t echnique with rods or screws or with iliosacral screws. We have devised a n ew fixation system, in which iliosacral screws are combined with iliac scre ws. This is; made possible by using the AO Universal Spine System with side opening hooks above and below the iliosacral screws and iliac screws below it. The whole sacropelvis is thus encompassed by a maximum width (MW) fixa tion, which gives an 'M' appearance on the pelvic radiographs and a 'W' app earance in the axial plane. We report on our surgical technique and the ear ly results where such a technique was used, We feel that this new means of fixation (by combining the strongest fixation systems) is extremely solid a nd should be included in the wide armamentarium of sacropelvic fixation.