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306 Chapter 8 Cervical and Thoracic Spine

A traditional way to dctect this stiffness when anky-losing spondylitis is suspcctcd is to use a tape measure to assess the apparent changc in length of the spine between flexion and extension. This is done by measuring the distance between the vertebra prominens and the sacrum with a tape measure when the patient is standing erect. The patient is then instructed to bend forward as far as possible, and the same interval is measured (Fig. 8-17). A variant of this techniąue is the modified Schober test, which ąuantifies lumbosacral flexion. To perform this measurement, the examiner marks points 10

Figurę 8-15. Active thoracic flexion.

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