Degree of flexibility of the kyphosis: Differentiate between the supple and the rigid shape.
Procedure
Patient standing upright (observe from the side).
- The patient is inspected while they stand in an upright position.
- There is often a strong forward tilting pelvis and a strong lumbar lordosis in addition to the exaggerated kyphosis.
- The patient bends over slowly, with the arms hanging down and both palms loosely against each other.
- The shoulder blades drop in a downwards and lateral direction so that they no longer block the view of the spine.
- Observe whether there is a kink in the thoracic kyphosis [Figure 52].
Interpretation
If this is the case, it may concern a rigid form of an exaggerated thoracic kyphosis.
Figure 52
- If there was a kink visible, the patient should try to move the shoulders and head in a dorsal direction.
- Observe from the side, whether the thoracic kyphosis reduces.
Interpretation
If this is the case, then it concerns a supple thoracic kyphosis. If not, then it may be a rigid kyphosis and one can obtain additional information by performing further tests with the patient in prone position.
Patient in prone position.
- The patient lies completely flat in prone position on the examination table with the arms alongside the torso.
- Palpate the thoracic spinous processes and conclude whether the thoracic kyphosis has disappeared [Figure 53].
Interpretation
If this is the case, it concerns a supple thoracic kyphosis.
Figure 53
- If the thoracic kyphosis does not disappear when the patient is lying down, the patient should lift their head, chest and arms from the examination couch.
- Observe whether the thoracic kyphosis is reduced.
Interpretation
If this is the case, it concerns a supple thoracic kyphosis.