Clinical anatomy : official journal of the American Association of Clinical Anatomists & the British Association of Clinical Anatomists
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A palpation reference line coursing between the superior-most aspect of the iliac crests has been reported to cross the L4 spinous process or L4/L5 intervertebral space in approximately 80% of the population. Comparable data have not been defined for the line coursing between the posterior superior iliac spines (PSIS). The purpose of this study was to compare the anatomical consistency of the PSIS to the iliac crest as landmarks used for spinal palpation. ⋯ The PSIS crossed S2 more frequently than the iliac crest crossed L4 (chi(2) = 12.719, P < or = 0.01). The study findings support the relationship between the PSIS, and the spinous process of S2 is more consistent when compared to the iliac crest and the spinous process of L4. The PSIS reference line may be used to find S2 as a reference standard in validity and reliability palpation studies in the lower lumbar spine.
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The birth of conjoined twins occurs in approximately 1 in 50,000 to 1 in 100,000 deliveries, and the majority are either stillborn or die early in life. Approximately 184 successful separations have been described. The authors describe the preoperative radiologic evaluation of a set of thoracopagus-omphalopagus twins and their successful surgical separation. ⋯ Successful separation of twins conjoined by several organ systems requires a multispecialty approach. Preoperative knowledge of shared anatomy is necessary for adequate preparation and planning. Despite meticulous preoperative investigations, certain anatomy can only be discovered at the time of surgery, and the ability to adjust to these findings is imperative.