Abstract
M.Tech. (Chiropractic)
The most accepted method of identifying the second sacral spinous
process is by using an accepted landmark known as the Posterior
Superior Iliac Spines (PSIS). The PSIS lies about 4cm lateral to the
second spinous tubercle of the sacrum (Williams and Warwick, 1980).
However, in a search of published work, no evidence could be found of
any study which established these generally accepted statements
(Stonelake, 1983).
This was an inter-examiner reliability study aimed to determine whether
palpation of the PSIS was a reliable and accurate method of determining
the location of the second sacral spinous process (S2) in participants
experiencing lumbosacral joint dysfunction.
Thirty participants were marked by three examiners in the prone position
using the PSIS to locate S2. An x-ray was taken of each participant in the
prone position, after being marked by all three examiners. Measurements
were then made on the x-rays to assess the location of the markers on the
sacral anatomy.
The reliability. of palpation of anatomical landmarks needs to be validated
further in future studies, as motion palpation and the palpatory
assessment of effectiveness of treatment, applied to correct motion
restrictions, are predicted- upon accurate localisation of anatomical
landmarks (O'Haire and Gibbons, 2000).