Frequently Asked Questions


Frequently Asked Questions Text Only Vervsion

Can surgery help to remove bone that has fused ?

Surgery is now far more successful than in the past. There is a better understanding of how to prevent damage to the spinal cord and less invasive methods. However, surgery does not give normal function back if your spine is fused. It fuses your spine in a forward facing position instead of in a curved or downward facing position. Surgery will be considered if :

the spine is unstable (i.e. has fractured or will fracture)

there is a great deal of deformity which makes functioning very difficult (i.e. eating etc)

there is nerve damage

Parts of the spine can be stabilized with rods and screws and parts of the spine can be removed in order to adjust the posture and correct bending in the neck or back. However, surgery to the spine and neck does carry a risk.

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Of 84 people who had surgery for correction of deformity in Germany, 34 had neck surgery and 50 had spinal (back) surgery. The surgery was a success in giving people an forward facing head and straighter spine in 83 people but one person was left with paraplegia a day after the operation (i.e. paralyzed from the body down). Wound infection occurred in 2 people and healed with treatment.

Surgery can not simply chip off the fused bits leaving an un-fused and fully mobile spine.

Should I get my children tested for the B27 gene ?

No. If you have ankylosing spondylitis there is a 5 in 10 chance that your child will have the B27 gene. In fact 8 in 100 people carry this gene . The B27 gene is not enough by itself to develop ankylosing spondylitis. Other genes and a trigger are needed for ankylosing spondylitis to develop. So knowing that a child has the B27 gene does not mean anything. Instead you should be aware that pain and swelling in the knees, foot or ankle could be the development of arthritis in children and so you should have a doctor check these symptoms. You should always encourage children to be active and to do sports or exercise and to investigate pain and swelling were there has not obviously been an injury.

Does ankylosing spondylitis go into remission after the age of 40 ?

Some people do report to have less symptoms with time. The level of disease activity is slight lower with increasing disease duration but it is not clear if this is because people get used to the pain and fatigue. In a study of 100 people with AS in Norway more than 8 in 10 people still had pain and stiffness after 20 years of disease and 6 in 10 still took daily drugs. The number of flares of disease a person experiences does not get less with time or age. Therefore, it appears that in the majority of people AS does not go into remission but in a lucky few [perhaps 2 in 10 people] it may get less with time.

References :

Saghir H, Boehm H. Surgical options in the treatment of spinal disorders in ankyloisng spondylitis. Clin Exp Rheumatol 2002; 20(Suppl.28): S101-S105.

Gran J, Skomsvoll J. The outcome of ankylosing spondylitis : a study of 100 patients. Br J Rheumatol 1997; 36:766-71.

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