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6/15/2015
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BASE POSTERIOR SACRUM
INSTRUMENTATION
An instrumentation break will usually occur at the
lower 1/3 of the L5 spinous.
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PHYSICAL EXAM FINDINGS
• Motion palpation reveals a fixation at L5.
• Edema may be present between the
L5-S1 segments.
PHYSICAL EXAM FINDINGS
• Tenderness may be found over the S1 and S2
segments.
• Sudoriferous changes may be noted over L5
and S1.
LATERAL X-RAY
The lateral x-ray will usually
reveal a flexion malposition
of L5 on the sacral base.
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SACRAL BASE ANGLE
The sacral base angle is usually
less than 36 degrees.
LATERAL X-RAY
The lateral x-ray will usually
exhibit hypolordosis of the
lumbar spine.
GRAVITATIONAL STRESS LINE
If the Gravitational Stress Line
passes posterior to the anterior
one-third of the sacral base,
this suggests hypolordosis of
the lumbar spine.
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GEORGE’S LINE
The lateral x-ray will usually reveal
that the sacral base George’s line
is relatively posterior to the L5
George’s Line.
Sacral Compression Test
may relieve Base Posterior
Sacrum discomfort because
it may be closing the L5
posterior open disc wedge
(flexion malposition).
Sacral Distraction Test may
aggravate a Base Posterior
Sacrum because it is
increasing the L5 posterior
open disc wedge even
more (flexion malposition).
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BP TISSUE PULL
I-S Tissue Pull &
then extend the wrist.
Correct for Base
Posterior Sacrum.
LOC is P-A & I-S through the
midline of the L5 disc.
5