Gonstead
Handbook
The listing section
- I–II LearnLumbar and pelvic listings
- III NervoscopeHow the instrument finds the level
- IV QuizName the listing, or set it yourself
To change mode from any page, pull the wheel out from the right edge.
Reading the Lumbar Listing
Every listing describes how one segment misaligns relative to the segment below it. Wedging lives in the disc space between two bodies, which is why a single vertebra can never demonstrate it. Select a listing and watch L4 move into it.
- PPosterior. Always first, read from the lateral film.
- 2Which way the spinous has rotated.
- 3Wedging, taken on the side of spinous laterality.
- -MContact point — mammillary process in the lumbars.
Reading the views. The A–P view carries the wedge and the spinous laterality — it is where the second and third letters are decided. The lateral view carries posteriority, which is why the first letter is always taken from it.
The nucleus follows the open wedge. That migration is the reason the contact point sits where it does — the thrust aims at setting the body back onto it.
The Foundation Listing
The pelvis is listed differently. The ilium is read from the PSIS and moves relative to the sacrum; the sacrum is read from its base, and a dash marks it as a sacral listing.
Watch what happens above. Cycle ASIN against PIEX with the column on. The ASIN ilium loses lumbar curve; the PIEX ilium increases it — a small change at the foundation producing a large deviation higher up.
The Nervoscope
The instrument does not measure temperature. It measures the difference in skin temperature between the two sides of the spine, one probe either side of the spinous processes. A level spine reads nothing. Asymmetry deflects the needle — and asymmetry is what the listing has to explain.
- Probes straddle the spinous processes, light even contact, both touching skin.
- Glide caudad — down the spine — slowly and at a steady speed. Speed is the commonest error; too fast and the needle never settles.
- Where the needle deflects, stop. That level is a candidate.
- Go back over the spot and try to rub the deflection out.
- If it rubs out it was surface artifact. If it persists, the reading is real.
Why the rub matters. Both examples deflect the needle on the first pass and look identical at that moment. Only the second pass separates them: friction heat and surface irregularity disperse, a genuine neurological asymmetry does not. Run both and watch the first pass — the point is that you cannot tell yet.
And why this sits beside Plates I and II. The instrument finds the level. The listing describes what is wrong there. Neither replaces the other, and a compensation will pass the instrument while still looking misaligned on film.
Name the Listing
A segment is set into a listing. Turn it, read it the way the film is read, and name it. Lumbar and pelvic listings are mixed, and the streak runs until a miss. Pose it reverses the task: the listing is given and you set the bone.
Exact notation. Lumbar listings carry the contact point after a hyphen.