A pilot study to investigate the validity of the rule of threes of the thoracic spine

Michael A. Geelhoed, James A. Viti, Patricia A. Brewer

Research output: Contribution to journalArticle

3 Scopus citations


This report describes a pilot study conducted to determine the location of the transverse processes (TPs) of the thoracic spine relative to the location of their corresponding spinous processes (SPs). There are clinicians who recommend utilizing the "rule of threes" to locate the TPs of the thoracic spine. This rule was proposed by Mitchell in 1979 and adopted in many orthopedic and manual therapy texts, but it has not been validated with research. In this pilot study, five cadavers were dissected and measurements were taken between the TPs of one thoracic vertebra and the SP of the superior vertebra. Based on the results of this pilot study, the rule of threes was determined to not be an accurate predictor of the location of the TPs of the thoracic spine.

Original languageEnglish (US)
Pages (from-to)91-93
Number of pages3
JournalJournal of Manual and Manipulative Therapy
Issue number2
StatePublished - Jan 1 2005



  • Palpation
  • Spine
  • Thoracic Vertebrae

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation

Cite this