Do you have Ankylosing Spondylitis? If so, you may be a little apprehensive and curious about surgery. You may be wondering, "Will I have to have surgery?" But surgery is rarely necessary for this condition. Most people get better with medication and physical therapy. But in some severe cases, if other treatments don't control the pain and symptoms, your doctor may recommend surgery. Let's talk about this clearly and simply.
Why do you have to undergo surgery?
Keep in mind that not everyone with ankylosing spondylitis (AS) will need surgery. However, there are several main reasons why a doctor may consider surgery.
- If you have unbearable pain: If you have severe pain that cannot be controlled even with painkillers and is so severe that you cannot perform daily activities.
- If you cannot walk properly: If walking is difficult due to deformities in the spine and joints, muscle weakness, or pain.
- If a spinal fracture causes nerve compression: Sometimes, when the bones in the spine are broken (fractures), the broken pieces can compress the spinal cord or the nerves that come from it. This can be dangerous and requires surgery.
The most important thing is that this decision is made by your doctor, who knows your condition best. He will examine your condition carefully and decide whether surgery is necessary or not.
What types of surgeries are performed?
There are several types of surgery for AS. The type of surgery you choose will depend on what your problem is. Let's look at the main types of surgery. Most of these surgeries are performed under general anesthesia, meaning you are completely asleep and not aware of anything.
| Name of the surgery | What happens with this? | A short description |
|---|---|---|
| Laminectomy | It relieves pain by reducing pressure on the spinal nerves. This is the most common surgery for AS. | A bony part of the spine called the lamina is removed to make more room for the nerves. Additional bone grafts or metal rods may be used to stabilize the spine. It takes 1-2 hours, and you may be able to go home the same day. |
| Osteotomy | A surgery to straighten the spine and correct posture for people with kyphosis. This is done very rarely. | A piece of bone is removed from the spine and the spine is realigned. This makes walking easier and reduces pain. You may have to stay in the hospital for about 5-7 days. |
| Spinal Fusion | A surgery to stabilize the spine. Often, the two surgeries mentioned above are performed together. | Using metal rods and wires, the vertebrae in the spine are connected and stabilized. This speeds up the healing process. It takes 2-7 hours and requires a 2-4 day hospital stay. |
| Hip Replacement | It is done for people who have severely damaged the hip joint due to AS and are in so much pain that they cannot walk. | The damaged hip joint is removed and replaced with an artificial joint made of metal, ceramic, or plastic. You may need to stay in the hospital for 1-2 days. |
What are the risks of surgery?
Surgery for AS is usually successful. However, as we know, there are some risks with any surgery. It is important to be aware of them.
Risks of spine surgery
- Problems that may occur during anesthesia (e.g., memory loss, breathing difficulties, serious conditions such as heart attack or stroke)
- Blood clots
- Lung problems, for example, pneumonia
- Wound infection
- Loose or dislodged metal implants
- Damage to the nerves in the spinal cord
- Pain that persists or worsens after surgery
- Putting more pressure on other parts of the spine, causing them to wear out more quickly
Risks of hip replacement surgery
This surgery has a very high success rate, but very rarely the following can occur:
- Blood clots
- Infections
- Dislocation of the transplanted joint
How do you prepare for surgery?
The best way to recover quickly from surgery is to prepare well for it. Here are some things you can do.
- Make a list of questions: Write down all the questions you have, from the small to the big, on a piece of paper and go see the doctor. Ask clearly about what to expect from the surgery, the recovery time, and the risks.
- Tell your doctor about all the medications you take (including vitamins and herbal remedies).
- If you smoke, stop now: Nicotine significantly delays wound healing. It is essential to quit smoking before surgery.
- Follow instructions about food, drink, and medication: Ask your doctor how many hours before surgery you should stop eating and drinking, and if you should stop taking certain medications, and follow them accordingly.
- Arrange for someone to help around the house: If you live alone, arrange for someone to help you shop, cook, and do other things after your surgery.
- Organize your home environment: Keep things you need frequently (phone, TV remote, water bottle) within easy reach. Move things around to make it easier to walk around the house. Remove things like pillows and cords that can trip you up.
Recovery time after surgery
Remember that it takes time to recover. Be patient. Even if it is uncomfortable, it is important to move and walk as much as possible according to medical advice.
Your doctor will refer you to physical therapy or give you exercises to do at home. Be sure to do those things. Your surgeon will give you clear instructions on what you can and cannot do after surgery (such as lifting weights, bending).
Important: If there are signs of wound infection (e.g. redness, swelling, pus, fever), or if your pain is getting worse, call your doctor immediately. In severe cases, go to the Emergency Department (ETU) of the nearest hospital.
Take-Home Message
- Surgery is rarely needed for ankylosing spondylitis (AS). Most people don't need it.
- Surgery is only recommended in severe cases, such as unbearable pain, difficulty walking, or nerve compression, and when other treatments have failed.
- There are several types of surgery (such as Laminectomy, Osteotomy) that may be suitable for your problem. Your doctor will explain these to you.
- Preparing well before surgery (asking questions, quitting smoking, preparing the house) goes a long way toward speeding up recovery.
- Be patient during your recovery, follow your doctor's instructions and physical therapy instructions carefully, and inform your doctor immediately if you experience any problems.
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