Ankylosing spondylitis

What is it?

Ankylosing spondylitis (AS) is a type of arthritis that mainly affects the back, by causing inflammation in the spine. This can make patients’ back, rib cage and neck stiff and painful. In response to inflammation, the body produces extra calcium around the bones of the spine. In some cases, a few bones of the spine may link up, or fuse together because of the extra calcium. While ankylosing spondylitis mainly affects the neck and back, it can also cause pain and stiffness elsewhere in the body, including in the hips, shoulders and feet.

Symptoms

In the early stages, ankylosing spondylitis is likely to cause stiffness and pain in the lower back in the morning that lasts approximately one hour, and then eases through the day or with activity. The pain and stiffness in the spine can vary over time. If most of the spine is affected, it can cause difficulty with activities that involve bending, twisting, or turning. If ankylosing spondylitis lasts for a long time or if the bones in the spine have fused together, there is a risk of fractures of the vertebrae, which can cause serious nerve damage.

Diagnosis

Diagnosis is made based on several things, such as the history of the condition and the symptoms, a physical examination, blood tests, x-rays or a magnetic resonance imaging (MRI) scan, and patient age.

Treatment

Treatment

Several different non-surgical treatments can slow down and treat pain and stiffness in ankylosing spondylitis:

  • Drug treatments – painkillers and non-steroidal anti-inflammatory drugs (NSAIDs)
  • Biological therapies
  • Steroids
  • Physical therapies

Surgery

Any decision about surgery is difficult and should also involve an experienced spinal surgeon. Though it’s rare for people to need surgery on their back because of ankylosing spondylitis, it can dramatically improve some people’s lives.

Any of the criteria below might warrant surgery, either alone or in combination with each other:

  • Chin-on-Chest Deformity
  • Spinal Instability
  • Pain radiating down the path of the nerve and into a limb
  • Numbness or tingling in limbs or extremities
  • Muscle weakness in a limb
  • Bladder or bowel incontinence

 

The type of spine surgery that surgeon recommends is based on many factors, including symptoms, the severity of the spinal deformity, rigidity of the spine, age, lifestyle, and overall health. Sometimes the surgery involves one or more procedures: laminectomy, spinal Instrumentation with fusion, and osteotomy.

Recovery

Post-operative period can be challenging. Bracing for at least 6 to 12 weeks after surgery is normal, as well as X-rays every three to six months to check healing progress.