Correction of sagittal balance within the iliosacral joints

To present an innovative technique to correct a complex spinopelvic deformity by addressing the main sagittal deformity within the sacroiliac joints.

Clinical case report of a 17-year-old female twin with a complex spine deformity in a VACTERL syndrome. Surgery involved ligament release and mobilization within the sacroiliac joints, followed by rotation of the sacrum in the sagittal plane and combined with correction of lumbar hyperlordosis.

Posture was significantly improved immediately after surgery and maintained 3 years postop.

Ligament release, mobilization within the sacroiliac joints, and sacrum repositioning are proposed as an innovative technique to correct a complex spine deformity with its origin within the pelvis.