Opposite Rotation of the Ilia

From the March 2008 The “G”Note

When the lumbar vertebrae have a right spinous rotation, the left ilium will usually have an AS or In major, and the right ilium a PI or Ex major.

When the sacrum, as view on the AP film, shows the tubercle rotated towards the right, the result is a P-L (posterior-on-the-left) sacral listing. The left ilium will usually have an AS or In major, and the right ilium a PI or Ex major. The reverse is true as well, that is, P-R sacral listing with a right ilium As or In major. I assume this is normal compensation.

On rare occasions, the ilia will demonstrate opposite rotation, e.g., left ilium PI or Ex major and the right ilium AS or In major with right lumbar spinous rotation (PR listing if lumbar subluxation present) and right sacral tubercle displacement (P-L sacral listing).

I don’t know why this occurs, acute vs. chronic, disc herniation, etc. Something to think about.

Dr. Alex Cox told me: “Never adjust an ilium and a lumbar on the same visit. Always make the adjustment that will help the patient the most.” Wise words.

Opposite Rotation of the Illia-3-08

Left ilium AS3In9; sacrum P-L 9; and L5 PLS-sp.

Opposite Rotation of the Illia-3-08_a

Left ilium is AS1In4; sacrum P-L 3; and L5 PLS-M