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Chiropractic Research Review

Sacral Obliquity: A Useful Gauge of Normal Lumbopelvic Spinal Alignment

The sacrum is an important structure in terms of assessing spinal integrity, although the prevalence, magnitude and clinical implications of sacral structural asymmetry have not been adequately explored in the literature.

In a retrospective analysis designed to determine how often, and with what magnitude, relative and sacral obliquity were observed on radiographs in the clinical setting, researchers evaluated 95 erect antero-posterior (AP) X-rays from 85 randomly selected patients (average age: 38.9 years) at a multipractitioner chiropractic center. All radiographs had been taken as part of each patients clinical assessment and treatment program.

Researchers assessed three specific variables on each X-ray: absolute femur-head angle (AFHA), absolute sacral-base angle (ASBA), and absolute iliac-crest angle (AICA), from which positional structural relationships were then calculated as x-axis rotations.

Results: "The data indicates that the clinician would expect to find patients have a sacral obliquity of about 3˚, a leg length inequality of 1.7˚, and an inequality of the iliac crests of about 2˚." According to the author, these data suggest that sacral obliquity is significant in defining normal lumbopelvic spinal alignment and "has implications for the clinician in defining [patients'] functional parameters and structural integrity," particularly in terms of performing postural evaluations or recommending sitting, standing and/or lifting postures.

As pointed out by the author, this is a preliminary study that needs follow-up. Specific implications for the clinician, and their importance, must still be explored.

Dulhunty J. A preliminary study of sacral base obliquity measured on erect radiographs taken in a clinical setting. Chiropractic Journal of Australia, June 2004;34(2):68-75.

Chiropractic Research Review

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