Sacrum

Question 1

Where will instrumentation break occur for posterior rotation of sacrum

Answer 1

S1-S2

Question 2

Where is point tenderness for posterior rotation of sacrum

Answer 2

S1/s2 tubercles

Question 3

What static palpation is found for posterior rotation of sacrum

Answer 3

Prominence of the lateral inferior angle of the sacrum (base)

Question 4

If the width of the sacrum on XRAY is 6+ difference then posterior rotation is on what side?

Answer 4

Larger/wider side is posteriorly rotated

Question 5

Posterior rotation of the sacrum is usually on what listing of the ilium?

Answer 5

IN

Question 6

How to find sacral inferiority

Answer 6

Place parallel ruler on femur head line and roll up to higher sacral groove.

If higher sacral groove is opposite to side of posterior rotation of sacrum then sacral inferiority is present on posterior rotation and listing becomes:
PI-L or PI-R

Question 7

When to adjust sacrum over ilium

Answer 7

If AS or IN or ASIN on side of posterior rotation of sacrum. Adjust sacrum over ilium

Question 8

When to adjust ilium over sacrum

Answer 8

PI or EX or PIEX on side of posterior rotation, adjust ilium (bigger numbers)

Question 9

Where will there be a break in a base posterior sacrum

Answer 9

Lower 1/3 of L5 SP

Question 10

Motion palpation fixation for base posterior sacrum

Answer 10

Fixation at L5

Question 11

Physical exam findings for base posterior sacrum

Answer 11

Fixation at L5

Sudoriferous changes at L5/S1 and potentially edema

Question 12

Lateral XRAY reveals a flexion malposition of L5 on sacral base

Answer 12

Base posterior

Question 13

Sacral compression test

Answer 13

Tests for base posterior

S2 tubercle with super hand and TP I-S and P-A with an arcing motion

+ = reduction of pain

Question 14

Sacral compression test—testing for what?

Answer 14

Base posterior sacrum

Question 15

Sacral distraction test —testing for what

Answer 15

Base posterior sacrum

Question 16

Sacral distraction test

Answer 16

S3 tubercle with inferior hand TP S-I and P-A with arcing motion down

+ = increased pain (irritates/stretches L-S junction and capsules)

Question 17

Way to determine grade for L5 spondylolisthesis

Answer 17

Meyerding’s method grades

Question 18

Main complain in pain across the lumbosacral junction

Answer 18

Base posterior sacrum

Question 19

Flexion malposition (open wedge at L5/base) seen on what

Answer 19

Base posterior sacrum

Question 20

What are Ddx that need to be ruled out for base posterior sacrum

Answer 20

L5 spondylolistesis

L5 disc syndrome

Question 21

Chief complain is lumbosacral pain due to an L5-S1 facet syndrome

Answer 21

Apex posterior sacrum

Question 22

Instrumentation break for apex posterior sacrum

Answer 22

Lower 1/3 L5 spinous

Question 23

Physical exam findings for apex posterior sacrum

Answer 23

Fixation at L5
Sudoriferous changes over L5/S1 and edema
Tenderness over L5 SP

Question 24

Positive Van Akkerveeken Measurement

Answer 24

When the posterior inferior tip of L5 projects past the posterior superior tip of sacrum.

Draw lines between and where they intersect = A. Measure distance from each.

If AB is 4 or +mm SHORTER than AC = posterior misalignment of L5 on sacrum indicated

Question 25

Lateral XRAY finding for apex posterior

Answer 25

Increased sacral base angle (more than 45 degrees)

Question 26

Increased sacral base angle

Answer 26

Apex posterior sacrum

Lumbar hyperlordosis

Question 27

Ferguson’s weightbearing line passed anterior to the anterior superior tip of the sacral base

Answer 27

Indicates hyperlordosis and apex posterior sacrum

Question 28

Any distal angle greater than ____ degrees is a sign of?

Answer 28

15

Severe facet syndrome

Question 29

Macnab’s line drawn where

Answer 29

Drawn across the inferior plate of line of L5

Question 30

Positive macnab’s line

Answer 30

Superior facet of S1 is projecting above the inferior plate line of L5

=facet imbrication

Question 31

Lateral xray indicators for apex posterior sacrum

Answer 31

-increased sacral base angle (45+)
-+ van akkerveeken (AB line shorter 4mm)
-increased L5 disc angle
+ Macnab line
-Ferguson’s weightbearing line anterior to yt6pol;00iu8l;poe3[]’gt