My brother is 33-years old and has had ankylosing spondylitis since he was 16. He can barely stand up straight anymore. He refuses to do the exercises the therapist gave him. Can anything be done for him?
Ankylosing spondylitis (AS) is one of several inflammatory arthritic conditions in a family of related diseases called spondyloarthropathies. Chronic inflammation occurs at the place where ligaments and tendons insert into the bone. The body reacts to the inflammation and ends up fusing the joints by replacing the soft tissues around the joints with bone.
The spine and sacroiliac joints are affected most often resulting in a forward bent posture. The patient may lose the ability to lie down flat, stand up straight, or look where he or she is going.
Your brother may be a good candidate for surgery to fuse the spine in a more upright position. One operation called an opening wedge osteotomy may be helpful. The surgeon cuts several vertebral bones loose and rotates or tilts them backwards.
Metal rods and screws are used to hold the spine in this new position until the bone fills in and fuses. The effect of this operation is to extend or straighten the spine and give the patient a more upright posture.
Not everyone with AS is a good candidate for this procedure. Other methods of fusion may work better. An orthopedic surgeon is the best one to make this determination and answer your questions. Your brother may be more willing to see a doctor if a family member goes with him.
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