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A novel and accurate palpation method for identification of the L4 spinous process

Effective physical examination of patients with back pain is essential for several clinical specialties, including rheumatology, orthopedics, neurology, anesthesiology, physical medicine, chiropractic, and physical therapy. Accurate identification of lumbar spinous process (SPs) as landmarks is fundamental to such examination; however, identifying lumbar SPs through manual palpation has been shown to be surprisingly inaccurate. During a clinical trial using precisely placed accelerometers to assess zygapophyseal joint cavitation, a novel method of palpation was used to improve palpation accuracy.