CT of pelvis and sacrum

Think You Know The Sacrum? – Think Again!

In the Summer of 1945 Sutherland and the Lippincotts together studied prenatal and newborn development, which led to the famous quote

“As the twig is bent, so the tree inclines”

Sutherland meant that if a strain is left in the body early in life, the child’s growing body organises itself around that strain and adapts to it as best it can.

Development Of The Sacrum

Sutherland was alluding to the condylar parts, but this might also be true of the sacrum as more recent MRI studies have shown it has complex and diffuse ossification process.

In 1998 Broome et al conducted MRI, CT and conventional X-ray studies investigating the postnatal maturation of the sacrum and coccyx. Their main finding was that the sacrum and coccyx have up to 60 sacral ossification centres.

They also found that ossification could be asymmetric, carried on to the age of 30 and that understanding this process would help distinguish physeal plates from possible fracture lines.

Palpated Findings?

For cranial osteopaths dealing with sacral compression and other strain patterns, understanding the complexity of sacral ossification and how it changes over time might be important when interpreting palpated findings associated with clinical history, e.g. traumatic or extended birth, pelvic injury or falls in later life.

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Postnatal maturation of the sacrum and coccyx: MR imaging, helical CT, and conventional radiography.

Broome DR1, Hayman LA, Herrick RC, Braverman RM, Glass RB, Fahr LM.

DOI Link

Pelvis CT Image: By Bjoertvedt (Own work) [CC-BY-SA-3.0], via Wikimedia Commons