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Ankylosing Spondylitis

Ankylosing spondylitis is a potentially debilitating condition mainly characterized by inflammation of the spinal and pelvic joints as well as some other joints throughout the body. It is a form of spondyloarthritis, and it has a very strong genetic connection that suggests it is largely hereditary. In its most advanced and rarest phase, ankylosing spondylitis can cause joint capsules and ligaments to fuse with the bone, and eventually the fusing of the bones themselves due to bony overgrowth – a process called ankylosis. This can result in an additional condition caused kyphosis, or the forward curvature of the spine.

Cause and Prevalence

While the exact cause of ankylosing spondylitis is unknown, there are strong indications that it is at least influenced by heredity. More than 95 percent of Caucasians with ankylosing spondylitis bear a particular genetic marker, but it is not necessary to carry that marker, and most people who do carry it do not develop ankylosing spondylitis. Additionally, the ratio of people with the genetic marker to those who have the disease varies greatly among different ethnicities. There is some indication that other factors (such as an infection) may couple with yet another gene to trigger the disease in people who are already susceptible to it. One theory holds that bacteria may enter the sacroiliac joint through the bloodstream in the intestines when intestinal defenses are lowered.

Symptoms and Treatment

Stiffness and pain in the sacroiliac joints – the union of the ilia (hip bones) and the sacral spine – are a universal symptom among patients with ankylosing spondylitis. Back pain and tenderness may last several months and then disappear, only to reemerge later. “Flare-ups” may be very severe or non-existent. In mild to moderate cases, non-steroidal anti-inflammatory drugs (NSAIDs) are normally effective in reducing pain and swelling; other medications such as Methotrexate or Sulfasalazine (known as disease modifying anti-rheumatic drugs, or DMARDs), are believed to be even more effective.

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Ankylosing spondylitis is a chronic condition with no cure. Thus, the only treatments available are aimed at managing the symptoms: pain relief, physical therapy, and regular visits to a rheumatologist can help to mitigate the pain, monitor the progress of the disease, and lower the chances of further complications and ankylosis. In severe cases, surgery may be necessary to correct deformities, such as severe spine curvatures, but there is always a chance of recurring ankylosis.

Please note: Laser Spine Institute currently does not perform endoscopic procedures on the thoracic spine.