Ankylosing Spondylitis Surgery: What You Need to Know

Ankylosing spondylitis (also called Bechterew’s disease) is a form of inflammatory arthritis and a condition that causes some of your vertebrae to fuse. Think about how you use your spine to bend, twist, and stretch throughout the day. You can enjoy such flexibility because your spine is made up of 26 connected vertebrae instead of one large bone. As your vertebrae start to fuse, your range of motion decreases. If this affects your ribs, you might even have a hard time breathing.


Surgery is one treatment option for patients with ankylosing spondylitis. It allows them to restore their range of motion and reduce their overall discomfort. If you have recently been diagnosed with Bechterew’s disease, you might be a candidate for this operation. Learn more about your surgical options to treat ankylosing spondylitis and what the preparation, risks, and recovery look like.


Who is a Candidate for Ankylosing Spondylitis Surgery?

The first thing to know if you were recently diagnosed with ankylosing spondylitis is that your doctor won’t rush you into surgery. There are plenty of people who live with this condition and seek out different treatment options that work for them. Even if your doctor eventually recommends you for surgery, they will likely try multiple different options first.


Your doctor will likely start your treatment with a combination of medications and physical therapy. They will recommend a series of stretches you can do at home or professionals you can meet with to treat your pain. The medications might include nonsteroidal inflammatory drugs (NSAIDs) and pain relievers. If your ankylosing spondylitis responds well to the medication, you might not need surgery.


Surgery is often recommended for patients who experience a spinal fracture or have severe joint damage that impacts their mobility. A doctor might recommend surgery if:


  • You experience severe pain that cannot be reduced by medications.
  • You cannot move your head or look forward because of your spinal fusion.
  • You feel numbness or tingling in your arms and legs, which indicates pressure on the spinal nerves.
  • You cannot drive, work, or enjoy the things you love in life because of limited mobility or pain.


Each of these signs highlights how surgery might be necessary to restore your ability to feel comfortable and move around.


Types of Ankylosing Spondylitis Surgery

Multiple types of surgery treat ankylosing spondylitis and your neurosurgeon should walk you through the different options and the procedure they recommend for you. Your doctor’s goal is to choose the safest method that will still have the biggest impact on your mobility and pain levels, so you can get back to living your life without pain and restricted mobility. Here are a few options.


Spinal Fusion

The goal of this surgery is to stabilize your spinal column so it no longer impacts the nerves that run up and down your back. Your doctor might fuse two or more vertebrae using rods, bars, or screws. This operation is meant to reduce your pain levels by limiting the amount of stress you put on your nerves. It can also help you regain control of your neck and head.



If your ankylosing spondylitis is causing your spine to curve, an osteotomy might be able to help. This is a form of spinal fusion that restores your vertebrae to a straight line (or a more natural curve). The surgery will reduce the amount of pressure that your vertebrae put on each other, which can also treat your pain levels.


Disc Replacement

Your final surgical option is a disc replacement, which is designed to restore your mobility while stabilizing the spine. In this operation, the surgeon will remove any damaged spinal discs that might have broken or fallen out of place in between your vertebrae. The damaged discs will be replaced by artificial options that are more durable and secure within the spine. This operation can help you bend and twist again because your spine will gain some extra flexibility.


Preparing for Ankylosing Spondylitis Surgery

Your doctor will walk you through the process of preparing for ankylosing spondylitis surgery. They will schedule multiple medical evaluations to see how your body responds to medication and whether the physical therapy improves your condition. If you follow the doctor’s program carefully but don’t see any results, you may be a candidate for surgery.


Before the operation, your doctor may request that you make some lifestyle changes to increase your chances of a positive outcome. They might ask you to stop smoking, improve your overall diet, and start low-impact exercises (like swimming) to improve your heart health. Your doctor will also recommend a series of preoperative tests that will confirm that you are a good candidate for surgery.


Completing each step of this process can increase the chances that your surgery is successful while reducing your risk of infection or complications during the recovery process.


The Ankylosing Spondylitis Surgery Process

Before your surgical appointment, your doctor will prepare you for what to expect. They will walk you through the duration of the procedure, patient recovery time, and anesthesia options.


Surgery can vary greatly depending on the patient and the operation needed, but medical procedures are becoming safer and less invasive than ever. For example, if you are a candidate for disc replacement, you might have an outpatient operation at a surgical clinic where you can go home to recover within a few hours.


Depending on the location of the ankylosing spondylitis surgical operation, your doctor will either make the incision into your back or enter through the front to avoid the nerve canal. With modern technology, most incisions are only an inch or two long because digital cameras and robots allow doctors to operate with smaller instruments. These tools make the operation less invasive, which can decrease both your recovery time and your risk of infection.


Once the operation is complete, your doctor will let you recover in the surgical center. Once the nursing staff is confident that you are in stable condition, they will send you home. Every operation comes with some form of risk, but today’s medical professionals take every possible step to ensure your safety and chances of success.


Recovery After Ankylosing Spondylitis Surgery

In the same way that your doctor will provide instructions and documents to prepare you for surgery, they will also give you information on how to navigate the recovery process. The hard work begins after you leave the hospital or surgical center. Now it is up to you to rest as much as you can and follow the physical therapy guidelines. Here are a few best practices for recovering after ankylosing spondylitis surgery:


  • Follow your pain management guidelines. Your prescribed medications are meant to reduce inflammation, reduce your pain levels, and potentially fight infections.
  • Complete your physical therapy exercises. Move when your doctor says it is safe and regularly complete any stretches or activities they recommend.
  • Do not lift heavy objects or return to work until your doctor clears you for these activities. Often, patients are restricted from lifting anything heavier than a sack of flour for the first few weeks after surgery.
  • Keep up with your adjustments to daily living. If you gave up smoking before the operation, don’t return to this habit.
  • Make appointments for follow-up care. Make sure you report any problems or concerns to your doctor. They want to make sure you are on the path to recovery.


You don’t have to try to recover faster than expected from your spinal surgery. In fact, the longer you give your body to heal, the better you should feel in the long run.


Potential Risks and Complications

Throughout the surgical process, from when you first receive clearance to your post-operative check-ins, your doctor will take steps to make sure you are healthy and safe. However, some potential risks can come with your ankylosing spondylitis operation. These include:


  • Infection
  • Blood clots
  • Nerve damage
  • Difficulty breathing
  • Adverse reactions to anesthesia
  • Allergic reactions to medications


Your doctor will walk you through the risks that come with your specific operation and recovery. Depending on the type of operation and location of the surgery, you could face different complications. They should also give you advice on how to prevent certain complications and when to take action. For example, if you have difficulty breathing, you should seek medical help immediately instead of waiting for your next follow-up appointment.


Alternative Treatments for Ankylosing Spondylitis

It is perfectly understandable that you might not be ready for surgery at this time. If you are a candidate for surgery but don’t want to proceed with this operation, talk to your doctor about your options. They might be able to develop a long-term medication program that (along with physical therapy) allows you to live with ankylosing spondylitis. Many people live with this condition for years and never need surgery because of it.


Additionally, you might be able to improve your overall health (along with your spinal health) by increasing your exercise habits and making lifestyle changes. Your doctor might recommend changing how you work to reduce the pressure placed on your spine. Small lifestyle changes can add up and make a big difference in how you feel each day.


Choose a Doctor You Can Trust

In the same way that neurosurgeons don’t recommend procedures lightly, you shouldn’t rush into choosing a doctor to treat your ankylosing spondylitis. Make sure you work with a leading medical professional who knows what they are doing but also listens to patients and makes them feel cared for.


If you are searching for a doctor to treat your spinal conditions, request a consultation with Dr. Todd H. Lanman, a board-certified, award-winning spinal neurosurgeon. Dr. Lanman himself has undergone eight spine surgeries (four cervical, four lumbar) which fuels his passion for helping people restore their mobility and reduce their pain levels. Make an appointment today and take the first steps toward good spinal health.

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