Sacrum Flashcards
Where will instrumentation break occur for posterior rotation of sacrum
S1-S2
Where is point tenderness for posterior rotation of sacrum
S1/s2 tubercles
What static palpation is found for posterior rotation of sacrum
Prominence of the lateral inferior angle of the sacrum (base)
If the width of the sacrum on XRAY is 6+ difference then posterior rotation is on what side?
Larger/wider side is posteriorly rotated
Posterior rotation of the sacrum is usually on what listing of the ilium?
IN
How to find sacral inferiority
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
When to adjust sacrum over ilium
If AS or IN or ASIN on side of posterior rotation of sacrum. Adjust sacrum over ilium
When to adjust ilium over sacrum
PI or EX or PIEX on side of posterior rotation, adjust ilium (bigger numbers)
Where will there be a break in a base posterior sacrum
Lower 1/3 of L5 SP
Motion palpation fixation for base posterior sacrum
Fixation at L5
Physical exam findings for base posterior sacrum
Fixation at L5
Sudoriferous changes at L5/S1 and potentially edema
Lateral XRAY reveals a flexion malposition of L5 on sacral base
Base posterior
Sacral compression test
Tests for base posterior
S2 tubercle with super hand and TP I-S and P-A with an arcing motion
+ = reduction of pain
Sacral compression test—testing for what?
Base posterior sacrum
Sacral distraction test —testing for what
Base posterior sacrum
Sacral distraction test
S3 tubercle with inferior hand TP S-I and P-A with arcing motion down
+ = increased pain (irritates/stretches L-S junction and capsules)
Way to determine grade for L5 spondylolisthesis
Meyerding’s method grades
Main complain in pain across the lumbosacral junction
Base posterior sacrum
Flexion malposition (open wedge at L5/base) seen on what
Base posterior sacrum
What are Ddx that need to be ruled out for base posterior sacrum
L5 spondylolistesis
L5 disc syndrome
Chief complain is lumbosacral pain due to an L5-S1 facet syndrome
Apex posterior sacrum
Instrumentation break for apex posterior sacrum
Lower 1/3 L5 spinous
Physical exam findings for apex posterior sacrum
Fixation at L5
Sudoriferous changes over L5/S1 and edema
Tenderness over L5 SP
Positive Van Akkerveeken Measurement
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
Lateral XRAY finding for apex posterior
Increased sacral base angle (more than 45 degrees)
Increased sacral base angle
Apex posterior sacrum
Lumbar hyperlordosis
Ferguson’s weightbearing line passed anterior to the anterior superior tip of the sacral base
Indicates hyperlordosis and apex posterior sacrum
Any distal angle greater than ____ degrees is a sign of?
15
Severe facet syndrome
Macnab’s line drawn where
Drawn across the inferior plate of line of L5
Positive macnab’s line
Superior facet of S1 is projecting above the inferior plate line of L5
=facet imbrication
Lateral xray indicators for apex posterior sacrum
-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
