Adjustment of the fetal head and adult pelvis in modern humans

In nonhuman anthropoids, the anteroposterior (AP) diameters of the fetus are greater than the transverse (TR) diameters and the AP diameters of the pelvic planes are greater than the TR diameters: during labor, therefore, the fetus moves through the birth canal without changing position or orientation. In modern humans, the fetal head at term is encephalized and the fetal chest is flattened. The maternal pelvic inlet is flattened in an AP direction, the sacral promontory and the ischial spines are prominent. As a result, AP<TR at the inlet, but AP>TR at the midpelvis and outlet. In addition, the birth canal presents a marked sacral curvature in the AP direction. The human fetus successfully negotiates the birth canal because the three crucial fetal adaptations: (1) spheroidicity of the presenting part of the fetal head, which allows it to “roll” in the pelvis; (2) mobility of the head and chest in all directions; and (3) a capacity for cranial molding, which adapts fetal head dimensions to pelvic dimensions. The result is that the human fetal head and chest can perform multiple rotational movements in order to always present the greatest fetal diameters to the greatest pelvic diameters. Monkeys show a limited degree of encephalization and suffer from narrow TR pelvic diameters without any possibility of fetal adaptations as shown by humans. Apes also show some encephalization but, because of wider TR diameters in the pelvis, they achieve an easy delivery with no need of fetal adaptations.     

Pelvic function in anuran jumping: Interspecific differences in the kinematics and motor control of the iliosacral articulation during take‐off and landing

Although the anuran pelvis is thought to be adapted for jumping, the function of the iliosacral joint has seen little direct study. Previous work has contrasted the basal “ lateral‐bender ” pelvis from the “ rod‐like ” pelvis of crown taxa hypothesized to function as a sagittal hinge to align the trunk with take‐off forces. We compared iliosacral movements and pelvic motor patterns during jumping in the two pelvic types. Pelvic muscle activity patterns, iliosacral anteroposterior (AP) movements and sagittal bending of the pelvis during the take‐off and landing phases were quantified in lateral bender taxa Ascaphus (Leiopelmatidae) and Rhinella (Bufonidae) and the rod‐like Lithobates (Ranidae). All three species exhibit sagittal extension during take‐off, therefore, both pelvic types employ a sagittal hinge. However, trunk elevation occurs significantly earlier in the anuran rod‐like pelvis. Motor patterns confirm that the piriformis muscles depress the urostyle while the longissimus dorsi muscles elevate the trunk during take‐off. However, the coccygeoiliacus muscles also produce anterior translation of the sacrum on the ilia. A new model illustrates how AP translation facilitates trunk extension in the lateral‐bender anurans that have long been thought to have limited sagittal bending. During landing, AP translation patterns are similar because impact forces slide the sacrum from its posterior to anterior limits. Sagittal flexion during landing differs among the three taxa depending on the way the species land. AP translation during landing may dampen impact forces especially in Rhinella in which pelvic function is tuned to forelimb‐landing dynamics. The flexibility of the lateral‐bender pelvis to function in sagittal bending and AP translation helps to explain the retention of this basal configuration in many anurans. The novel function of the rod‐like pelvis may be to increase the rate of trunk elevation relative to faster rates of energy release from the hindlimbs enabling them to jump farther. J. Morphol. 277:1539–1558, 2016. © 2016 Wiley Periodicals, Inc.     

Ontogeny and evolution of pelvic diameters in anthropoid primates and in Australopithecus afarensis (AL 288-1)

Pelvic diameters (both anteroposterior [AP] and transverse [TR]) were investigated in a series of anthropoid primates. The ratio of diameters (AP/TR) in each of three pelvic planes (inlet, midpelvis, and outlet) was calculated. In addition to the above, the length of the iliac, pubic, and ischial axes and the angles between these axes were determined. The AP/TR ratio at the pelvic inlet is (reported in millimeters, +/- SD, unless otherwise specified) 1.81 +/- 0.27 in New World monkeys (Cebidae) and Macaca mulatta; 1.53 +/- 0.17 in hylobatids and pongids; 0.87 +/- 0.08 in Homo sapiens; and 0.58 in Australopithecus afarensis (AL 288-1). The AP/TR ratio in the midpelvis is 1.61 +/- 0.23 in nonhominid primates (Cebidae, M. mulatta, hylobatids, and pongids), 1.12 +/- 0.11 in humans, and 0.59 in AL 288-1. In monkeys (Cebidae and M. mulatta), hylobatids, pongids, H. sapiens, and AL 288-1, the ratios of the length of the pubic axis over the ischial axis were 0.84 +/- 0.06, 0.95 +/- 0.07, 1.10 +/- 0.15, and 1.46, respectively; the pubis-ilium angles were 96 +/- 11, 120 +/- 10, 131 +/- 11, and 147 degrees, respectively; and the ischium-pubis angles were 106 +/- 11, 86 +/- 8, 96 +/- 7, and 68 degrees, respectively. In none of these pelvic features was AL 288-1 "intermediate" between pongids and H. sapiens. The anatomical peculiarities of the pelvis in AL 288-1 are explained primarily as the result of early adaptation to erect posture, which resulted in the reduction of the distance between the sacroiliac joint and the hip joint. As a consequence, the sacral promontory moved toward the pubic symphysis, and this resulted in shortening of the AP diameter and widening of the TR diameter at the pelvic inlet.     

High assimilation of the sacrum in a sample of American skeletons: Prevalence,pelvic size,and obstetrical and evolutionary implications

High assimilation sacrum is fusion of the caudal‐most lumbar vertebra to the first sacral vertebra. Previous studies have shown that high assimilation is associated with clinical problems, including obstetrical difficulty. This study used adult American males (n = 1,048) and females (n = 1,038) of the Hamann–Todd and Terry skeletal collections to determine the prevalence of high assimilation and its effect on pelvic size, and to consider the obstetrical and evolutionary implications of high assimilation. The prevalence of high assimilation in this sample is 6.3%, with males and females not differing significantly from one another in their prevalence. This prevalence is near the median for that reported in 41 other samples. In both males and females, individuals with high assimilation have significantly longer anteroposterior and posterior sagittal diameters of the inlet, and shorter sacrum compared to those with a nonassimilated sacrum. Females with high assimilation have a significantly narrower sacral angulation (i.e., reduced inclination of ventral axis of sacrum), and shorter posterior sagittal diameter of the outlet compared to those with a nonassimilated sacrum. A short posterior sagittal diameter of the outlet is associated with childbirth difficulty. As high assimilation is partial homeotic transformation of a lumbar vertebra, this study supports previous research that homeotic transformation of vertebrae is selectively disadvantageous. Am J Phys Anthropol, 2009. © 2008 Wiley‐Liss, Inc.     

Four‐dimensional analysis of early pelvic girdle development in Rana temporaria

A key event in vertebrate evolution is the linkage of the appendicular to the axial skeleton. The present study investigates the developmental dynamics of pelvic girdle morphogenesis in Rana temporaria up until metamorphosis, with respect to its functional and spatio‐temporal organization. The main questions to be addressed are: initial location and the number of elements contributing to pelvic girdle formation, mechanism of bridging between the pelvic anlage and the sacrum and arthrogenesis. Serial histological sections of specimens from Gosner Stages 30 to 41 were bright‐field microscopically examined and 3D‐reconstructed. 3D‐models were merged to 4D‐animations illustrating the complex developmental dynamics through time. The results reveal the initial formation of a single mesenchymal condensation located close to the appendicular skeleton, but far from the axial skeleton. In addition, our analysis detects a thin connective tissue strand in R. temporaria guiding the elongation of the ilium towards the sacrum. The 4D‐visualization allows novel insight into the ilio‐sacral bridging process and the reorientation of the pelvis. J. Morphol., 2011. © 2010 Wiley‐Liss, Inc.     

The effects of squatting while pregnant on pelvic dimensions: A computational simulation to understand childbirth

Biomechanical complications of childbirth, such as obstructed labor, are a major cause of maternal and newborn morbidity and mortality. The impact of birthing position and mobility on pelvic alignment during labor has not been adequately explored. Our objective was to use a previously developed computational model of the female pelvis to determine the effects of maternal positioning and pregnancy on pelvic alignment. We hypothesized that loading conditions during squatting and increased ligament laxity during pregnancy would expand the pelvis. We simulated dynamic joint moments experienced during a squat movement under pregnant and non-pregnant conditions while tracking relevant anatomical landmarks on the innominate bones, sacrum, and coccyx; anteroposterior and transverse diameters, pubic symphysis width and angle, pelvic areas at the inlet, mid-plane, and outlet, were calculated. Pregnant simulation conditions resulted in greater increases in most pelvic measurements – and predominantly at the outlet – than for the non-pregnant simulation. Pelvic outlet diameters in anterior-posterior and transverse directions in the final squat posture increased by 6.1 mm and 11.0 mm, respectively, for the pregnant simulation compared with only 4.1 mm and 2.6 mm for the non-pregnant; these differences were considered to be clinically meaningful. Peak increases in diameter were demonstrated during the dynamic portion of the movement, rather than the final resting position. Outcomes from our computational simulation suggest that maternal joint loading in an upright birthing position, such as squatting, could open the outlet of the birth canal and dynamic activities may generate greater pelvic mobility than the comparable static posture.     

A new reconstruction of Sts 14 pelvis (Australopithecus africanus) from computed tomography and three-dimensional modeling techniques

The purpose of this study is to propose a new reconstruction of the australopithecine Sts 14 pelvis from original fossils. Digital models created from CT images allow us to perform mirroring operations, select valid regions after digital interposition, and reassemble parts. The key-element of the reconstruction is the sacroiliac joint, restored from right and left articular surfaces, which places of the pubic symphysis close to the sagittal plane. The complete pelvis is obtained by 3D model mirroring of hip-bone and sacrum. The present reconstruction of the Sts 14 pelvis is consistent with Schmid's (1983) [Folia Primatol. 40, 283-306, 1983] and Häusler and Schmid's A.L. 288-1 [J. Hum. Evol. 29, 363-383, 1995] pelvic reconstructions by illustrating a relatively platypelloid shape of the pelvic cavity and laterally inclined iliac blades. The pelvic morphology suggests that australopithecines had a less posteriorly tilted sacrum in erect posture than modern humans. As compared with Lovejoy's [Am. J. Phys. Anthropol. Suppl. 50, 460, 1979] A.L. 288-1 pelvic reconstruction, the less transversely flattened shape of the Sts 14 pelvic cavity led to obstetrical mechanics characterized as in humans by ante-ischiatic birth and a curved trajectory. We deduce a human-like movement of rotation and flexion of the fetal skull in the Sts 14 pelvic cavity.     

Sexual Dimorphism in the Pelvis of <Emphasis Type="Italic">Microcebus</Emphasis>

Pelvic sexual dimorphism occurs in many anthropoid species and is often attributed to obstetric selection on female pelvic morphology. Few studies of pelvic dimorphism have included strepsirrhine taxa, which typically have relatively smaller infants than those of anthropoids. Because smaller female primates give birth to relatively larger infants, it is possible that the pelves of Microcebus, the smallest extant primate genus, will show some evidence of selection on obstetric adequacy. A comparison of adult female and neonatal body masses indicates that individual neonatal Microcebus are relatively large compared to adult female body mass, even though members of the taxon frequently produce twins. I examined variation in the bony pelvis within a sample of Microcebus. I measured specimens from a single locality, which probably represent 1 population. I measured 8 pelvic and 3 femoral variables to investigate skeletal size and pelvic size and shape dimorphism. Females significantly exceed males in absolute values of sacral width, pelvic height, pubic length, and distances from the pubic symphysis to the ischial tuberosity and points on the sacrum. Measurements of the femur are not significantly greater in females, suggesting that the pelvic differences are not due to skeletal size dimorphism. Significant pelvic shape or ratio differences, calculated via the geometric mean of 5 variables as the denominator, included greater relative pubic length and sacral width in females. Hence selection for obstetric adequacy may occur in the extremely small-bodied Microcebus.     

Sexual dimorphism in the human bony pelvis, with a consideration of the Neandertal pelvis from Kebara Cave, Israel.

Sexual dimorphism of the human pelvis is inferentially related to obstetrics. However, researchers disagree in the identification and obstetric significance of pelvic dimorphisms. This study addresses three issues. First, common patterns in dimorphism are identified by analysis of pelvimetrics from six independent samples (Whites and Blacks of known sex and four Amerindian samples of unknown sex). Second, an hypothesis is tested that the index of pelvic dimorphism (female mean x 100/male mean) is inversely related to pelvic variability. Third, the pelvic dimensions of the Neandertal male from Kebara cave, Israel are compared with those of the males in this study. The results show that the pelvic inlet is the plane of least dimorphism in humans. The reason that reports often differ in the identification of dimorphisms for this pelvic plane is that both the length of the pubis and the shape of the inlet are related to nutrition. The dimensions of the pelvis that are most dimorphic (that is, female larger than male) are the measures of posterior space, angulation of sacrum, biischial breadth, and subpubic angle. Interestingly, these dimensions are also the most variable. The hypothesis that variability and dimorphism are inversely related fails to be supported. The factors that influence pelvic variability are discussed. The Kebara 2 pelvis has a spacious inlet and a confined outlet relative to modern males, though the circumferences of both planes in the Neandertal are within the range of variation of modern males. The inference is that outlet circumference in Neandertal females is also small in size, but within the range of variation of modern females. Arguments that Neandertal newborns were larger in size than those of modern humans necessarily imply that birth was more difficult in Neandertals.     

The evolution of jumping in frogs: Morphological evidence for the basal anuran locomotor condition and the radiation of locomotor systems in crown group anurans

Our understanding of the evolution of frog locomotion follows from the work of Emerson in which anurans are proposed to possess one of three different iliosacral configurations: 1) a lateral‐bending system found in walking and hopping frogs; 2) a fore‐aft sliding mechanism found in several locomotor modes; and 3) a sagittal‐hinge‐type pelvis posited to be related to long‐distance jumping performance. The most basal living (Ascaphus) and fossil (Prosalirus) frogs are described as sagittal‐hinge pelvic types, and it has been proposed that long‐distance jumping with a sagittal‐hinge pelvis arose early in frog evolution. We revisited osteological traits of the pelvic region to conduct a phylogenetic analysis of the relationships between pelvic systems and locomotor modes in frogs. Using two of Emerson's diagnostic traits from the sacrum and ilium and two new traits from the urostyle, we resampled the taxa originally studied by Emerson and key paleotaxa and conducted an analysis of ancestral‐character state evolution in relation to locomotor mode. We present a new pattern for the evolution of pelvic systems and locomotor modes in frogs. Character analysis shows that the lateral‐bender, walker/hopper condition is both basal and generally conserved across the Anura. Long‐distance jumping frogs do not appear until well within the Neobatrachia. The sagittal‐hinge morphology is correlated with long‐distance jumping in terrestrial frogs; however, it evolved convergently multiple times in crown group anurans with the same four pelvic traits described herein. Arboreal jumping has appeared in multiple crown lineages as well, but with divergent patterns of evolution involving each of the three pelvic types. The fore‐aft slider morph appears independently in three different locomotor modes and, thus, is a more complex system than previously thought. Finally, it appears that the advent of a bicondylar sacro‐urostylic articulation was originally related to providing axial rigidity to lateral‐bending behaviors rather than sagittal bending. J. Morphol., 2011. © 2010 Wiley‐Liss, Inc.     

Sexual dimorphism in relative sacral breadth among catarrhine primates

As the sacrum contributes to the size and shape of the birth canal, the sexually dimorphic sacrum of humans is frequently interpreted within obstetric contexts. However, while the human sacrum has been extensively studied, comparatively little is known about sacral morphology in nonhuman primates. Thus, it remains unclear whether sacral sexual dimorphism exists in other primates, and whether potential dimorphism is primarily related to obstetrics or other factors such as body size dimorphism. In this study, sacra of Homo sapiens, Hylobates lar, Nasalis larvatus, Gorilla gorilla, Pongo pygmaeus, Pan troglodytes, and Pan paniscus were evaluated for sexual dimorphism in relative sacral breadth (i.e., the ratio of overall sacral breadth to first sacral vertebral body breadth). Homo sapiens, H. lar, N. larvatus, and G. gorilla exhibit dimorphism in this ratio. Of these, the first three species have large cephalopelvic proportions, whereas G. gorilla has small cephalopelvic proportions. P. pygmaeus, P. troglodytes, and P. paniscus, which all have small cephalopelvic proportions, were not dimorphic for relative sacral breadth. We argue that among species with large cephalopelvic proportions, wide sacral alae in females facilitate birth by increasing the pelvic inlet's transverse diameter. However, given the small cephalopelvic proportions among gorillas, an obstetric basis for dimorphism in relative sacral breadth appears unlikely. This raises the possibility that sacral dimorphism in gorillas is attributable to selection for relatively narrow sacra in males rather than relatively broad sacra in females. Accordingly, these results have implications for interpreting pelvic dimorphism among fossil primates, including hominins. Am J Phys Anthropol 152:435–446, 2013. © 2013 Wiley Periodicals, Inc.     

Variation of pelvic diameters due to different scanning positions--the experimental study

The distortion of human pelvis X ray scans, due to different scanning positions, can cause huge mistakes in estimation of pelvic diameters. The aim of the study was to quantify distortion of pelvic diameters in relation to scanning inclination angles. Twenty anatomically defined spots on the pelvis of a young male cadaver, freed of soft tissues, were marked with 3 mm metal balls. The digitalized X-ray scans were made with seven different but similar inclination angles, and marked spots were recognized by computer software. Obstetrical-gynecological (Ob-Gyn), horizontal and vertical diameters were measured between marked spots, and percentages of distortion were calculated for each new scanning position. Twenty seven distances on human pelvis from seven X-ray scans varied from -35.9% to 28.3%, on average 0.47%. This study has pointed to a high variation of vertical pelvic dimensions (4.94 +/- 5.73%), consequently making them unreliable in the estimation of general pelvic shape, and low variation of horizontal dimensions (0.92 +/- 0.61%). Generally, the percentage of variation of pelvic dimensions highly increases with inclination angle, in frontal and sagittal plane. Alteration of scanning distance by 4 cm has a weak influence on pelvic diameters. The most reliable Ob-Gyn pelvic diameter was conjugata diagonalis, then diameters obliqua prima and secunda, with an average length deviations of 3.4, 4.0, and 6.0% respectively. The conjugata anatomica was the most unreliable with an average variation of 11.5%.     

基于CT薄层扫描的骨盆数字化三维模型的分色构建

目的：探讨利用CT原始数据集对骨盆进行数字化三维分色构建的方法及意义。方法：选择1例因宫颈癌行盆腔CT薄层扫描患者的Dicom3．0原始二维断层数据集,利用Mimics10．01软件行骨盆三维分色重建。结果：构建的数字化三维分色模型形态规则、清晰逼真、立体感强、解剖清晰,不仅可以对构成骨盆的髂骨、骶骨及尾骨进行单独的三维分色显示,而且可以进行任意角度、距离的融合分离显示,更有利于对骨盆进行精细地全面立体观察分析。结论：基于CT薄层扫描数据集构建骨盆三维分色模型的方法简单、可行,是指导临床及教学的好工具。     

Skeletal and muscular pelvic morphology of hillstream loaches (Cypriniformes: Balitoridae)

The rheophilic hillstream loaches (Balitoridae) of South and Southeast Asia possess a range of pelvic girdle morphologies, which may be attributed to adaptations for locomotion against rapidly flowing water. Specifically, the connectivity of the pelvic plate (basipterygium) to the vertebral column via a sacral rib, and the relative size and shape of the sacral rib, fall within a spectrum of three discrete morphotypes: long, narrow rib that meets the basipterygium; thicker, slightly curved rib meeting the basipterygium; and robust crested rib interlocking with the basipterygium. Species in this third category with more robust sacral rib connections between the basipterygium and vertebral column are capable of walking out of water with a tetrapod-like lateral-sequence, diagonal-couplet gait. This behavior has not been observed in species lacking direct skeletal connection between the vertebrae and the pelvis. The phylogenetic positions of the morphotypes were visualized by matching the morphological features onto a novel hypothesis of relationships for the family Balitoridae. The morphotypes determined through skeletal morphology were correlated with patterns observed in the pelvic muscle morphology of these fishes. Transitions towards increasingly robust pelvic girdle attachment were coincident with a more anterior origin on the basipterygium and more lateral insertion of the muscles on the fin rays, along with a reduction of the superficial abductors and adductors with more posterior insertions. These modifications are expected to provide a mechanical advantage for generating force against the ground. Inclusion of the enigmatic cave-adapted balitorid Cryptotora thamicola into the most data-rich balitorid phylogeny reveals its closest relatives, providing insight into the origin of the skeletal connection between the axial skeleton and basipterygium.     

Sacral curvature and supine posture

Sacral curvature (SC), represented by the angle between the first and the last sacral vertebrae, is a feature that differentiates the human pelvis from that of other animals. The sacral curvature was measured and studied in 14 cebids, 31 cercopithecids, 17 hylobatids, 85 pongids, 23 normal human children, 15 children with orthopedic handicaps, 49 normal adult human males, and 64 normal adult human females. Sacral curvature was minimal to nil in monkeys (mean 11.5 +/- 6 SD degrees), and moderate in apes (hylobatids, mean 16 +/- 10 SD degrees; pongids, mean 27.2 +/- 16 SD degrees). In human newborns SC is minimal, increasing progressively until adolescence, reaching a mean of 64.7 +/- 29 SD degrees in adult humans. This study investigates the different factors contributing to the formation of the sacral curvature. These factors include 1) the effect of erect posture, which tilts the upper part of the sacrum dorsally and the lower part of the sacrum ventrally, and 2) the influence of supine posture, which affects the development of the lower part of the sacrum. In addition to supine posture the levator ani, which is well developed in Homo sapiens, also affects the lower part of the sacrum and coccyx and influences its ventral orientation. Variation in SC can result from differences in onset and frequency of supine posture. This is the first time that supine posture has been shown to play a role in shaping the human pelvis, although it is as characteristic of H. sapiens as is erect posture.     

Biomechanical Study on the Novel Biomimetic Hemi-Pelvis Prosthesis

A pelvic endoprosthesis is the primary means of pelvic reconstruction after internal hemipelvectomy. In this study, a novel biomimetic hemipelvic prosthesis, including an artificial ilium, an artificial acetabulum, and an artificial pubis, was developed. A Finite Element Method （FEM） was carried out to investigate the biomechanical performance of a pelvis reconstructed with biomimetic hemipelvic prosthesis. Two models, including the reconstructed pelvis and the original pelvis （control model）, were established according to the geometry from CT data of a human male patient with pelvic bone sarcomas. The FE models predict that the biomeehanical function of the pelvic ring can be reestablished using this prosthesis. Results show that the body force loaded on the S 1 vertebra is restored and transferred towards the sacro-iliac joint, and along the ilium onto the bearing surface of the artificial ilium, then to the artificial acetabulum and pubis. Von Mises stresses observed in this reconstructed pelvis model are still within a low and elastic range below the yielding strength of cortical bone and Ti6A14V. The values of deformation and strain of the reconstructed pelvis are close to the data obtained in the original pelvis. With the partial replacement of the pubis, little influence is found towards the pubis symphysis. However, the interface between the prosthesis and pelvic bone may become the critical part of the reconstructed pelvis due to the discontinuity in the material properties, which results in stress shielding and deformation constraining. So a biomimetic flexible connection or inter layer to release the deformation of pelvis is suggested in future designing.     

The lumbosacral transition: morphologic variations and their functional significance

The articular facet of a superior articular process of the sacrum is directed backward, inward, and upward with marked variations. 4 angles characterize the orientation of this facet: a) The relative angle of tilt: i.e. the angle between the articular facet and the upper end-plate of the sacrum, measured in a sagittal plane. b) The absolute angle of tilt: i.e. the angle between the articular facet and the horizontal plane, measured in a sagittal plane. c) The tilted part-angle of opening: i.e. the angle between the articular facet and the sagittal plane, measured in a plane parallel to the upper end-plate of the sacrum. d) The horizontal part-angle of opening: i.e. the angle between the articular facet and the sagittal plane, measured in a horizontal plane. These 4 angles are determined by characteristic straights within the articular facet and certain reference planes (upper end-plate of the sacrum, horizontal plane, sagittal plane). Only 2 intersecting straights suffice for an adequate determination of a geometrical plane; therefore, if we know the relative angle of tilt and the tilted part-angle of opening, we are able to construct or to calculate the absolute angle of tilt as well as the horizontal part-angle of opening by using the range of inclination of the sacrum. The shape as well as the orientation of the articular facets at the superior articular processes of the sacrum do not depend on the inclination of the pelvis nor on the inclination of the sacrum nor on the range of the lumbosacral angle. Only the absolute angle of tilt shows a reference to the inclination of the sacrum because the relative angle of tilt shows a certain constancy. The orientation of the articular facets is slightly influenced by static moments, but considerably determined by dynamical requirements. At spines with irregular numbers of praesacral vertebrae, the orientation of the lumbosacral articular facets do not differ from the orientation of these facets at spines with the regular number of 24 praesacral vertebrae. This, however, does not prove right at spines, that have a lumbosacral "transitional vertebra". Such lumbosacral transitional vertebrae detract much from the stability of the lumbosacral region of the spine.     

Measurement of soft tissue thickness over the sacrum of elderly hospital patients using B-mode ultrasound

The thickness of soft tissues over the sacrum of elderly hospital in-patients has been measured using B-mode ultrasound. Forty patients were scanned, of which nine had recognizable superficial pressure sores at the sacrum. No correlation was found between the depth of soft tissue and either age or Norton score. Patients with sores had less soft tissue over the sacrum (p < 0.025). Excluding one patient whose sacral sore appeared to be the final stage of the healing process, the remaining eight all had less than 8.5 mm of sacral soft tissue cover. Five patients without sacral sores also had less than 8.5 mm of sacral soft tissue cover. However, a combination of the presence of incontinence and the depth of sacral soft tissue cover identified seven of the eight patients with sacral sores with no inclusion of patients without sores.     

Soft tissue displacement over pelvic anatomical landmarks during 3-D hip movements

The position, in a pelvis-embedded anatomical coordinate system, of skin points located over the following anatomical landmarks (AL) was determined while the hip assumed different spatial postures: right and left anterior superior and posterior superior iliac spines, and the sacrum. Postures were selected as occurring during walking and during a flexion–extension and circumduction movement, as used to determine the hip joint centre position (star-arc movement). Five volunteers, characterised by a wide range of body mass indices (22–37), were investigated. Subject-specific MRI pelvis digital bone models were obtained. For each posture, the pose of the pelvis-embedded anatomical coordinate system was determined by registering this bone model with points digitised over bony prominences of the pelvis, using a wand carrying a marker-cluster and stereophotogrammetry. The knowledge of how the position of the skin points varies as a function of the hip posture provided information regarding the soft tissue artefact (STA) that would affect skin markers located over those points during stereophotogrammetric movement analysis. The STA was described in terms of amplitude (relative to the position of the AL during an orthostatic posture), diameter (distance between the positions of the AL which were farthest away from each other), and pelvis orientation. The STA amplitude, exhibited, over all postures, a median [inter-quartile] value of 9[6] and 16[11] mm, for normal and overweight volunteers, respectively. STA diameters were larger for the star-arc than for the walking postures, and the direction was predominantly upwards. Consequent errors in pelvic orientation were in the range 1–9 and 4–11 degrees, for the two groups respectively.     

On the Sacral Plexus and Sacral Vertebra of Lizards.

The authors mention that of late it has been recognized that, in any attempt to answer the question as to which vertebra of any lower animal answers to the first sacral vertebra of Man, the nervous no less than the osteological relations of the parts should be carefully investigated. And it has been considered that the nervous rather than the osteological relations should be deemed the more important: in fact it has been sometimes asserted that the nerves must be taken as the fixed points, and that the bones must rather have their homology decided by the nerves, than vice versa. Should it be possible to show that in any group of reptiles, both the nervous and osteological relatious of any vertebra constautly agree with the nervous and osteological relation of Man's first sacral vertebra, the homology between such two parts may well be taken as thereby established; but if either of these sets of relations exhibit discrepancy, then of course such homology cannot be considered satisfactorily determined. Nor can we justly set aside osteological in favour of nervous resemblances if it should turn out that the nerves themselves exhibit notable variations of conditions as we pass from one allied form to another–a fortiori if there should be variations in this respect even within the limits of a species. It might surely be anticipated that more or less variation would be found to exist inner‐vous as well as in skeletal structures; and in the event of such anticipations being justified, the determination of sacral homology must depend upon a comparison of the values of the conflicting claims of different degrees of resemblance in both the osseous and nervous systems–unless we prefer to consider the osteological sacrum and the nervous sacrum as two distinct structures, which may or may not completely coincide, and may or may not widely diverge. The authors afterwards discuss the opinions held by Professor Gegenbaur with regard to the pelvic relations in birds and some reptiles, also those of Professor Hoffmann concerning the lumbar and sacral plexuses of Batrachians and Reptiles. Then follows an account of dissections of the Chameleon (Cha‐mceleo vulgaris), the Green Lizard (Laeerta viridis), the common Teguexin (Teius teguexin), the Bearded Lizard (Grammatophora barbata), the Agama colonorum, the Tuberculated Lizard (Iguana tuberculata), and of the Monitor (M. arenaria). On these dissections are based some remarks on the general condition of the nervous and osseous structures of the sacral region in Lizards, according to their views and as compared with those held by G‐egenbaur and Hoffmann. To this succeed other chapters devoted to a consideration of the sacral region of Batraehians, to the sacral region of Mammals, and to the sacral region of Birds, each discussed in a similar spirit. Their generalizations to the foregoing may be thus summarized:– It appears, then, that in Lizards generally, the lumbar plexus may be formed by from two to three roots, aud that the most pre‐axial of these is here in advance of the fourth presacral nerve, while the most postaxial root is never more postaxial than the first presacral nerve. But Monitor and Ohamwleo present a slight exception in certain respects. In all the Eeptilia examined and enumerated by the authors, the transverse processes which abut against the ilium are wholly or in part parapophysial, and are in serial relation (serial liomo‐logues) with the capitular processes (or the capitular parts of the transverse processes) of the more preaxial vertebrae. The junction of the sacral vertebrae with the ilium is much postacetabular in Saurians; but in Crocodilia and Tortoises (some at least) it is about opposite the acetabulum. In Batrachians the transverse processes abutting against the ilium are parapophysial, but diapophysial in nature like those of Eeptiles. In Mammals as compared with Lizards, it would seem, with respect to nerves, that the first and second sacral vertebra? (say, for instance, of the Cat), answer very well to the two vertebrae with enlarged transverse processes of Lizards, while osteologically they of course also answer very well to them. There can be little doubt, however, that the first two sacral vertebrae of the Cat are to be considered homologous with the anterior human sacral vertebra¹; and therefore it would seem that the two ilium‐joining vertebrse of Lizards should be considered homologous with the anterior human sacral vertebrae. In Man, the Cat, and also in other Mammals down to the Echidna, the transverse processes abutting against the ilium are parapophysial, like those of Eeptiles and Batrachians. In all the Mammals examined by the authors, however, the junction of the sacral transverse processes with the ilia is preacetabular, although that junction is much less preacetabular in position in Man than it is in most Mammals. Altogether, from the osseous and nervous conditions evinced together in the groups hitherto referred to, the authors propose the following definition of a “Sacral Vertebra” in Mammals, Eeptiles, and Batrachians:–“ vertebra'ivithparapophysial transverse processes winch abut against the ilium, preaxial or post‐axial or opposite to the acetabulum, and having a root of the sciatic plexus coming forth either immediately preaxiad or postaxiad of it.” This definition will exclude from the sacrum, as not abutting against the ilium, of Man, the more posterior vertebrse called “ sacral” in anthropotomy. But in the lower mammals (even already in Apes) the number of so‐called “ sacral ” vertebrre augments more or less with age by the ankylosis of the sacral vertebras, so as not to render the extent of the “ sacrum ” very variable. It would surely be well, then, to distinguish the human sacral vertebra, like the ribs, into true and false, those being the true sacral vertebrae which abut against the ilium. In Birds the determination of the homological relations of the different parts of the postdorsal part of the spinal column is a matter of much difficulty. On the whole, and seeing on the one hand the manifest homology between the sacral vertebrae of Man and Lizards by the help of Crocodiles and Tortoises, and on the other hand the manifest homology between the sacral vertebrae of Lizards and the posterior parapophysial vertebras of most Birds, the authors think it better to regard the latter vertebras in Birds as alone truly sacral, and to regard such forms as Bwceros, Pica, and certain Parrots as differing from the rule of the Class in the suppression of their parapophysial processes, sm&Fregatta as differing from the same rule by the development of parapophyses in all the vertebras of this region. The sacral vertebra? in Birds may be defined, then, as “vertebrce having one of the more postaxial roots of the sciatic plexus coming forth either immediately preaxiad or postaxiad, and having parapophysial transverse processes abutting against the ilium, such vertebra being placed immediately postaxiad to vertebra which are devoid of such parapophyses, or else being the homologues of a vertebra so conditioned in most birds. By the combination of these two definitions, as given above (the one for Mammals, Eeptiles, and Batrachians, and the other for Birds), it seems to the authors that the sacral vertebras may be defined in all Vertebrata above Pishes which have pelvic limbs.