Sagittal Balance of the Spine in Ankylosing Spondylitis
Barend J. van Royen, Ben A. C. Dijkmans in Ankylosing Spondylitis Diagnosis and Management, 2006
Ankylosing spondylitis (AS) is an inflammatory arthritis that primarily affects the spine and sacroiliac joints (1–4). Advanced stages of the disease are characterized by a progressive stiffening of the spine and thorax as reactive syndesmophytes bridge the intervertebral disks and the entire spine becomes a fixed lever arm. The sagittal balance of the patient often deteriorates during the course of the disease, producing a rigid thoracolumbar kyphosis that can be a significant source of pain and disability. The surgical management of this deformity is complicated, with controversies regarding different treatment approaches (5–14). In this chapter, the clinical and radiographic evaluation of the thoracolumbar kyphosis and the secondary compensatory changes in sagittal alignment are reviewed. The preoperative planning of a corrective osteotomy is then discussed.
Test Paper 5
Teck Yew Chin, Susan Cheng Shelmerdine, Akash Ganguly, Chinedum Anosike in Get Through, 2017
Causes of intervertebral disc calcification include the following: Degenerative disc disease is a relative common cause for disc calcification.Alkaptonuria, or ochronosis, results in dense central calcification affecting the nucleus pulposus and is associated with generalised osteopaenia. Changes often start at the lumbar spine.Ankylosing spondylitis is a recognised cause; associated findings helping in narrowing the diagnosis.Calcium pyrophosphate dehydrate deposition disease (CPPD), haemochromatosis and hypervitaminosis D can result in calcification of the annulus fibrosus.Transient intervertebral disc calcification is seen in children, typically in the cervical spine and spontaneously regresses.Other recognised causes of disc calcification include juvenile chronic arthritis, amyloidosis, poliomyelitis, acromegaly, hyperparathyroidism, trauma and post-operative discs.
Chronic Pain Management and Arthritis
Deborah Fish Ragin in Health Psychology, 2017
After reading this chapter, you will be able to: Define and explain chronic pain.Identify and describe three major categories of pain.Identify and describe three factors that explain individual differences in pain perception.Identify and describe the three major types of arthritis.Explain ankylosing spondylitis.Identify and define three pharmacological therapies for arthritis.Define exercise therapy.Explain the benefits of exercise therapy for people with arthritis.Explain the role of psychological therapies for the treatment of arthritis.
Patients with ankylosing spondylitis have high risk of irritable bowel syndrome: a long-term nationwide population-based cohort study
Published in Postgraduate Medicine, 2022
Hao-Yuan Feng, Chi-Ho Chan, Yu-Cheng Chu, Xin-Man Qu, Yu-Hsun Wang, James Cheng-Chung Wei
Ankylosing Spondylitis is a chronic inflammatory disease, which mainly invades the sacroiliac joints of the lower spine. There is seldom a direct connection between AS and IBS. However, previous studies on autoimmune diseases and gastrointestinal disorders like gut inflammation or dyspepsia have been published. A case-control study indicated that autoimmune patients except those with endocrine autoimmune disorders might have a higher prevalence to develop functional gastrointestinal disorders (FGIDs), i.e. functional dyspepsia (FD), chronic idiopathic constipation (CIC), and multiple FGIDs [20]. Most recently, atopic and autoimmune diseases are risk factors for FGIDs in a population-based study [18]. In a longitudinal observation study, autoimmunity had the potential to cause post-infectious gut dysmotility [21]. Besides, a 5-year follow-up study reports that fecal calprotectin(FCP) level which is a crucial marker of intestinal inflammation increased in AS patients. Although the sample size of this research are not large, this research shows a strong relationship between gut inflammation and AS [22].
Budget impact analysis of secukinumab versus adalimumab in the treatment of ankylosing spondylitis
Published in Journal of Medical Economics, 2019
Timo Purmonen, Soili Törmälehto, Hanna Wahlman, Kari Puolakka
Ankylosing spondylitis (AS) is an inflammatory rheumatic disease primarily affecting the spine, but other joints and entheses can also be involved. Typically, symptoms start with stiffness and pain in the lower back and buttocks, but may spread to upper parts of the back and neck1,2. The onset of AS usually appears at early adulthood at the age of 20–30 years1. Inflammation tends to lead to fusion of vertebrae causing malposition of the spine, functional restrictions, and deterioration of the long-term health-related quality-of-life1,3,4. While the cause of AS remains unknown, gender and genetics are involved in the disease1. Men have a higher risk of developing AS compared to women1. The global prevalence of AS is 0.02–0.35%5, and the incidence is 0.44–7.3 per 100,000 person years6,7.
Clinical Characteristics and Prognostic Factors in Ankylosing Spondylitis Associated Uveitis
Published in Ocular Immunology and Inflammation, 2019
Ji Hwan Lee, Moonjung Choi, Tyler Hyung Taek Rim, Sung Chul Lee, Christopher Seungkyu Lee
Gender, age at onset, laterality, HLA-B27 typing, aqueous flare/cell/hypopyon, vitreous involvement or retinal vascular leakage, complications including cataract, posterior synechiae and secondary glaucoma, recurrences, treatment administered, and visual outcome were investigated. All patients underwent a complete eye examination including best corrected visual acuity, slit-lamp examination, ophthalmoscopy, and additional examinations including fluorescein angiography (Heidelberg Retina Angiograph System (HRA-2); Heidelberg Engineering, Heidelberg, Germany) when indicated. A review of systemic symptoms, laboratory, and radiological evaluations was performed and the diagnosis of ankylosing spondylitis was made by rheumatologists according to the modified New York Criteria.19 Patients were treated with topical steroids, cycloplegics, and peribulbar steroids as indicated. Systemic steroids were prescribed by the ophthalmologist in cases of refractory and severe uveitis, and immunosuppressant and biologic agents including infliximab (Remicade; Janssen, Titusville, NJ, USA), adalimumab (Humira; Abbvie, North Chicago, IL, USA), and etanercept (Enbrel; Amgen, Thousand Oaks, CA, USA) were concomitantly prescribed by the rheumatologists to treat associated systemic symptoms. Vitreous involvement or retinal vascular leakage included vitritis, clinically significant cystoid macular edema, retinal vasculitis, papillitis, and pars planar exudates.
Related Knowledge Centers
- Gastrointestinal Tract
- Inflammation
- Periodic Fever Syndrome
- Arthritis
- Vertebral Column
- Joint
- Autoimmune Disease
- Leukocyte Antigen
- Hla-B27
- Medical Imaging