Surgery For Ankylosing Spondylitis: Our Community's Experiences
Ankylosing spondylitis (AS) primarily affects the spine and sacroiliac joints (the joints that connect the pelvis to the lower spine), causing pain and stiffness. AS can progress to cause fused joints, where the bones grow together. This leads to more stiffness and decreased movement.
Treatment for AS usually includes a combination of medicines and physical therapy. While most people with AS do not need surgery, in some instances, surgery may be necessary.
As part of our 2nd Annual Ankylosing Spondylitis In America survey, we explored the surgery experiences of people living with the condition. Nearly 800 people with AS completed the survey and provided a unique look at how surgery has impacted them.
Surgical options with ankylosing spondylitis
Overall, more than 1 in 3 survey respondents shared that they have had surgery to treat AS or its complications. Because AS can impact various joints, surgery options may be different from 1 person to the next. The most common surgical options for those with AS include:
Laminectomy: This surgery creates space by removing the back part of the vertebral bone that covers your spinal canal. Also known as decompression surgery, this procedure helps to relieve pressure on the spinal cord or nerves. This was the most common spinal surgery among survey respondents.1
Spinal fusion instrumentation: This surgery strengthens and stabilizes the bones of the back using medical rods, hooks, or wires. The procedure “welds” 2 or more spinal bones together, so they grow together as 1 bone.2,3
Joint replacement: Also known as joint arthroplasty, this procedure removes the damaged joint and replaces it with a metal, plastic, or ceramic device. Hip involvement in AS occurs 30 to 50 percent of the time. This eventually leads to stiffness in the hip with decreased range of motion in the hip and back. For these reasons, hip replacement is a common surgical option for those with AS.4,5
Depending on the severity and location of damage, those with AS may have other surgical options to help treat AS or its complications. Some of these options may include surgeries to relieve nerve pain, shoulder surgeries, or other surgical procedures.
How many people with AS have surgery?
Of those we surveyed, 36 percent have had surgery to treat AS or its complications. This number may be deceiving because many others are considering surgery or are unhappy with their current treatment plan. In fact, of the 787 people surveyed, less than 10 percent feel their current treatment plan adequately controlled their condition.
Thoughts on surgery with AS and if it is helpful
Following the survey, we also turned to community members on our Facebook page and asked them to share their experiences with surgery for AS.* We asked them to tell us: “Have you had surgery because of your AS? Was it helpful?” Here is what the community said:
“Cervical spine fusion C5-C7. I wish the surgeon had done C4-C7 to be more stable. C4 now has both a disk bulge and a bone [spur] right on top of my hardware. Still, I think the surgery was helpful.”
“Multiple surgeries – some improvement, [but] not enough.”
“I had both my hips replaced at the same time and cervical spinal fusion surgery due to AS. The hip replacement helped tremendously.”
“[I had] both hips replaced, disc removed, and knee arthroscopy.”
“I had a total hip replacement in my right hip. I do need the other one done too. I am able to do more now. No constant pain.”
In summary: spinal surgery may be needed in AS. Results vary among everyone. AS may not go away, but surgery may be an option for some.
*Member comments are based on personal preference and experience and have been edited for clarity.
The Ankylosing Spondylitis/Axial Spondyloarthritis in America 2020 survey was conducted online from March through July 2020. Of the 1,181 people who completed the survey, 787 were people who have been diagnosed with ankylosing spondylitis, 289 people who were classified as generalized spondyloarthritis, 105 were people diagnosed with non-radiographic axial spondyloarthritis, and none were caregivers of people with ankylosing spondylitis/axial spondyloarthritis.
Other than back pain and fatigue, what is the most common symptom that AS patients experience?