Ankylosing spondylitis (AS) is a type of arthritis that primarily affects the spine. The disease is characterized by inflammation and resulting stiffness and pain in the joints along the spine. The knee and shoulder joints may also be affected.
With ankylosing spondylitis, the inflammation in the joints of the spine will typically result in parts of the vertebrae and joints in the spine fusing together. As parts of the vertebrae grow (or “fuse”) together, the spine becomes more rigid and inflexible.The fusion takes place as a reaction to inflammation of ligaments or tendons at the site of attachment to bone. The inflammation causes bone to erode at the site of the attachment, and then as the inflammation subsides, the body’s natural healing process causes new bone growths in its place.Because this new bone is stiff, as opposed to the elastic quality of the tissue or ligaments, the normal range of motion of the spine is diminished. Ankylosing spondylitis most commonly is diagnosed in young men between the ages of 15 and 30, although it can affect anyone. Almost everyone with ankylosing spondylitis carries a specific gene called HLA-B27.
When it is difficult to perform daily tasks or to look forweard because of the defomity caused by Ankylosing spondilitis, a surgical treatment to correct the kyphotic deformity is advised.
In this surgery, the spine is approached from the back and after exposure, screws are inserted. Then bone cuts are done to the spine to release the fused structures. a bone wedge (sometimes more then 1) is removed and the wedge is closed to correct the kyphosis. finally the screws are connected to a properly bent rod to hold the corrected spine in a stable position.
The aftercare of an ankylosing spondilitis patient is generally not different form a standard spinal deformity patient. Ambulation is encouraged the next day after surgery and the patients are generally discharged in a week .
Smoking or the use of a specific groups of drugs like steroids and TNF alpha blockers are strongly discouraged as they interfere with and sometimes totally prevent bone healing.