Ankylosing Spondylitis: Treatment in the Best Clinics

About the disease

Ankylosing spondylitis is an autoimmune disease, also known as the Bekhterev's disease. It mainly affects the spine and surrounding tissues. Other typical target of the disease is the sacroiliac joints. Bekhterev's disease causes inflammation that leads to arthritis and eventual joint immobility.

Usually the disease reveals itself between the ages of 15 and 35. It is more typical for men, ratio between male and female patients varies from 3:1 to 8:1. In addition, women usually have milder disease course.

Causes for ankylosing spondylitis are mostly genetic, as it can be passed from one generation to another. Bekhterev's disease has dominant inheritance, so all patient’s children will have the same condition.

Symptoms

Symptoms of Bekhterev's disease develop gradually, during several months or even years. They also can be unstable, getting better or worse without any treatment. Main complaints include:

• Constant pain in the back and pelvis
• Stiffness in the spinal column
• Inability to move freely
• Fatigue

Diagnosis

• Blood tests reveal non-specific signs of inflammation.
• Visualizing examinations – ultrasound, X-ray, MRI – give more precise information about state of spine and sacroiliac joints and determine the stage of ankylosing spondylitis.
• Genetic testing for the HLA-B27 gene can also confirm the diagnosis. Nevertheless, people with HLA-B27 gene can never suffer from Bekhterev's disease, being just a symptom-free carrier.

Treatment

• Medication is used to reduce pain in spine and joints. In addition to painkillers, doctors use anti-TNF medications. Anti-TNF drugs block effects of tumour necrosis factor and thus reduce inflammation in joints.
• Dorsal fixation or osteosynthesis in patients with neck fracture is a procedure, during which the cervical vertebrae are fixed to prevent spinal cord damage. 
• Neck angle correction is used to correct the curvature of this angle in case it was damaged by this disease. The neck spurs can also be removed during this procedure.
• Lumbar angle correction also corrects the angle if lumbar region changed. This makes spine more flexible.
• Joint replacement (sacroiliac joints) can be performed if the pain is too severe and there is no other option.
• Physical therapy brings beneficial results and has no side effects. Of course, the exercises must be moderate and individually selected. The most effective ones are jogging and aerobic therapy, which can be done in groups with a specially trained professional or at home. Thermotherapy can also help reduce symptoms. This treatment for ankylosing spondylitis is usually applied additionally to other treatment options.

Authors: Dr. Vadim Zhiliuk, Dr. Sergey Pashchenko