What if you have ankylosing spondylitis and your spine breaks? Let's talk about this!

Do you have Ankylosing Spondylitis, or AS as we all know it? If so, your spine's flexibility can gradually decrease over time, making it a bit more brittle, like a dry log. This is because AS can cause the vertebrae (what we call the bones of the spine) to fuse together and lead to conditions like osteoporosis, which weakens the bones. Because of this, sometimes you don't even think about it, even something as small as a fall while walking around the house can lead to a broken bone, or fracture. Today, let's talk about what to do in such a situation.

Why do you need surgery to stabilize a broken spine?

These types of fractures most often occur in the cervical spine, but they can also occur in the thoracic spine and lumbar spine.

Think of this as a fragile fracture, like a branch about to snap in two. The broken bone fragments can move around and pinch the spinal cord, the main nerve that controls our entire body and carries messages to the brain. It's like cutting the main electrical wire in our house.

If the spinal cord is damaged in this way, the communication stops. This can cause severe pain, numbness, and weakness. Sometimes, this can even be life-threatening. Therefore, the best and fastest way to protect your spinal cord is to have surgery to stabilize the injury as soon as possible.

What types of surgeries are performed to repair a spinal fracture?

The most common treatment for this condition is spinal fusion surgery. Simply put, this is when doctors insert a strong support inside your spine to stabilize it. They use a variety of things to do this.

• Screws
• Metal rods `(Rods)`
• Metal plates `(Plates)`
• Titanium cages
• Bone grafts

Sometimes, the doctor will also perform a decompression procedure during this surgery to relieve the pinched nerve. This can help reduce symptoms such as pain and numbness in your limbs.

There are different ways to perform this surgery. Your doctor will choose the best method based on the following factors:

• Where is your broken spine?
• Other illnesses you have
• The condition of your bones

What to expect before, during and after surgery?

Your doctor may decide that you need emergency surgery . If so, they will tell you how to prepare for it. They will tell you to stop taking certain medications, such as blood thinners. You will also often need to stop eating and drinking after midnight the night before the surgery.

The surgery can take several hours or more. You will be under general anesthesia during the entire procedure, which means you will not feel anything. After the surgery, you may feel some pain when you are taken to the ward, but the doctor will give you medication to manage it. You will have to stay in the hospital for a few days.

After the surgery,

• You may need to wear a cervical collar or a back brace for a while.
• The doctor also recommends that you undergo physical therapy.
• It usually takes about 3 months for the bones of the spine to fully heal.
• During that time, you will be told how to move around safely and work. It is very important to go to the clinics on the days the doctor says to come back and get an X-ray to see if your back is healing.

What are the risks and complications of this surgery?

As with any surgery, there are some risks. However, the benefits of surgery for spinal fractures due to AS far outweigh the risks.

The biggest risk is nerve damage. But the doctors are very careful about this. They even take great care when they put you on the operating table and turn you around for the operation.

In addition to nerve damage, some other complications that can occur include:

• Infections
• Lung infections such as pneumonia
• Bleeding
• Blood clots
• Difficulty breathing

Your doctor will talk to you about all of this before the surgery.

Can this be treated without surgery?

Surgery is the best and safest way to stabilize a fracture, especially in the neck. It is rare for a doctor to decide that surgery is too risky. However, some people may not be able to tolerate surgery due to other serious medical conditions.

If you decide not to have surgery, you will be told to wear a brace to keep your back immobile. You will also be told to completely avoid strenuous exercise and work, and to take bed rest.

How do you know if your spine is broken?

If you have AS, see your doctor right away if you experience any new pain, weakness, or numbness in your back. Don't take it lightly, even if it's just something minor like a slip and fall.

Back fractures in AS patients can sometimes occur without any falls, but they are most often caused by things like:

• Falling while walking or standing
• Bicycle accidents
• Vehicle accidents

It can be difficult to distinguish between the pain of a minor fracture and the pain of a common AS injury at first. Therefore, a CT scan or MRI scan is often needed to determine exactly what is wrong. It is more likely that these fractures will not be seen on a regular X-ray.

If it is confirmed that you have a fracture, your doctor will refer you to a spine surgeon. Seeing a doctor who has experience with AS patients will help you choose the treatment that is best for you.