Abstract
M.Tech.
In order to diagnose and treat a patient with a musculoskeletal complaint,
a manual medical practitioner relies upon clinical palpatory skills (O'Haire
and Gibbons, 2000). To compare palpatory findings between spinal levels
and across treatment sessions, Chiropractors must be able to locate
individual vertebral levels accurately and reliably (McKenzie and Taylor,
1997). There have been reports that the use of landmark palpation to
locate spinal levels is of questionable reliability (Burton, Edwards and
Sykes, 1990, Simmonds and Kumar, 1993).
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.