Ankylosing Spondylitis: Diagnosis and Management PDF

Preface

Ankylosing spondylitis is a chronic inflammatory disease that primarily affects the spine and sacroiliac joints, causing pain, stiffness, and a progressive thoracolumbar kyphotic deformity. In about one-third of the patients, peripheral joints are also affected. The aim of treatment is reduction of pain and stiffness, and to prevent a thoracolumbar kyphotic deformity or at least to minimize progression. Current conservative therapy consists of exercise programs and medical treatment, including nonsteroidal anti-inflammatory drugs and disease modifying anti-rheumatic drugs. Recently, biologicals (anti-tumor necrosis factor-a drugs) proved to be very effective in the treatment of ankylosing spondylitis. Most patients can be treated successfully with these conservative treatment modalities. A small group of patients, however, do develop a severe thoracolumbar or cervical kyphotic deformity. In these patients, corrective osteotomy of the spine may be considered. These osteotomies proved to be advantageous for numerous patients. However, occasional poor results and complications have diminished their acceptance by rheumatologists and orthopedic surgeons. This is not surprising, because there are still many unsolved questions concerning pre- and postoperative assessment of the deformity, and surgical procedures.

This book is designed to carry basic, biomechanical, and clinical essentials of ankylosing spondylitis and related rheumatological and orthopedic issues on applied research, medical, and surgical treatment. Emphasis is laid on difficulties with making a diagnosis (still mean eight years) and therapeutic advances. Potential readers include rheumatologists, orthopedic surgeons, orthopedic and rheumatological residents, orthopedic and rheumatological researchers, fellows, and graduate students. This is the first inclusive and interdisciplinary organized reference book on basic science and relevance to medical and surgical treatment of ankylosing spondylitis, a topic that has not been covered in any existing books.