Chapter 4

Question 1

At what articulations can sacrum become subluxated?

Answer 1

SI joint, lumbosacral joint

Question 2

If the sacral plane line is not parallel to the femur head line what is your first thought?

Answer 2

Malformation of the sacrum

Question 3

How would you confirm sacrum misalignment?

Answer 3

Check other bilateral points such as sacral foramina, etc

Question 4

If you are wrong about sacrum misalignment what do you check next? What is the result?

Answer 4

Check for sacral inferiority

Results in PI-L or PI-R?

Question 5

Describe the listing of sacrum?

Answer 5

Measure the right side of sacrum from S2 to the most lateral part and measure the left side of the sacrum from S2 to the most lateral part

Question 6

Requirements for listing sacrum?

Answer 6

A difference of 7mm is significant, but if you have a difference of 4-6mm with all vertebrae up to C2 following sacral rotation and there are no scolioses present sacrum may be listed

Question 7

How do you measure for sacral inferiority?

Answer 7

Roll your parallel to the highest sacral point from the femur head line and strike a line. If this coincides with the posteriorly rotated side then you have sacral inferiority

Question 8

When do you adjust sacrum to ilium?

Answer 8

Sacrum to ilium= If you have an ASIN, ASEX with AS major, or PIIN with IN major
Ilium to sacrum= If you have a PIEX, PIIN with PI major, or ASEX with EX major

Question 9

Differentiate between base posterior and posterior L5?

Answer 9

Sacrum will be posterior to the body of L5 (George’s Line) and you will have a posterior open wedge

Question 10

Who is susceptible to posterior sacral base/base posterior?

Answer 10

Preadolescent whose articular processes haven’t completely ossified

Question 11

Differentiate between base posterior and spondylo at L5?

Answer 11

BP will be the only posterior segement and the lumbars will stand on top of L5. An L5 spondylo will slip forward from sacrum and L4

Question 12

What film do you use to determine posteriority of sacral base?

Answer 12

Lateral

Question 13

With a spondylo at L5 can you expect total realignment?

Answer 13

It is rarely accomplished, NEVER adjust L4 with an L5 spondylo

Question 14

How does coccyx usually misalign?

Answer 14

Usually anterior, but may have lateral deviation

Question 15

When listing laterality of coccyx do you list the wedge or apex direction?

Answer 15

Listing (A-L= left is apex)