SONDYLOARTHRITIS

Questions and Answers

Symptoms:

Symptoms of spondyloarthritis may include chronic back pain, stiffness, fatigue, and reduced range of motion. While symptoms can vary between individuals, there are some common signs to watch out for. The hallmark symptom of spondyloarthritis is low back pain, particularly in the lower back and buttocks. This pain often has a particular characteristic: it’s persistent, lasting for at least three months, and tends to worsen at night or with inactivity. Unlike pain from injury, stiffness that improves with movement and exercise can be a clue that spondyloarthritis might be the culprit.

Diagnosis:

Diagnosis often involves a thorough medical history, physical examination, imaging studies (such as X-rays and MRIs), and blood tests to check for inflammatory markers and genetic factors. Diagnosing spondyloarthritis can be a multi-step process because early stages may not show on x-rays. Doctors will consider your medical history, perform a physical exam to assess your range of motion and tenderness, and may order imaging tests like MRI scans to get a clearer picture of your joints and spine. Blood tests are also sometimes used, although there’s no single blood test for spondyloarthritis. One test may look for the presence of the HLA-B27 gene, which increases the risk of developing spondyloarthritis, but not everyone with the gene will develop the condition. Through this combination of exams and tests, doctors can arrive at a diagnosis of spondyloarthritis and create a treatment plan to manage the condition.

Nonsurgical Treatment:

Nonsurgical treatments for spondyloarthritis aim to reduce inflammation, alleviate symptoms, and improve quality of life. This may involve medications such as nonsteroidal anti-inflammatory drugs (NSAIDs), disease-modifying antirheumatic drugs (DMARDs), biologic therapies, and physical therapy to improve flexibility and strengthen muscles.

Surgical Treatment:

In severe cases where nonsurgical treatments fail to provide relief, surgical intervention may be necessary. Surgical options include procedures to correct spinal deformities, such as spinal fusion, decompression surgeries to relieve pressure on nerves, and joint replacement surgeries for severely damaged joints.

Thankfully, surgery is rarely the first line of treatment. Medication, physical therapy, and lifestyle modifications are usually the cornerstones of managing spondyloarthritis. However, in some severe cases, surgery may be considered to address specific complications. Here’s a look at the limited surgical options for spondyloarthritis:

Why Surgery is Not Common:

Spondyloarthritis primarily causes inflammation, and surgery cannot address the underlying cause, and therefore, there is limited impact.

• Fusion vs. Flexibility: Spinal fusion procedures, which might seem helpful for stabilizing the spine, can actually worsen stiffness – a core symptom of spondyloarthritis.
• Risk vs. Reward: Surgeries are inherently invasive and carry risks. Given the focus on maintaining mobility in spondyloarthritis, the potential benefits often don’t outweigh the risks.

Surgical Options (when necessary):

• Joint Replacement: For severe joint damage, particularly in the hips, a total joint replacement surgery can significantly improve pain and function.
• Spinal Decompression: In rare cases, severe nerve compression caused by inflammation or bone overgrowth in the cervical spine (neck) might necessitate decompression surgery to create more space for the nerves.
• Spondylolisthesis Correction: Spondylolisthesis is a condition where one vertebra slips forward over another. If this slippage causes significant nerve compression or instability, surgery to realign the vertebrae and potentially fuse them for stability might be an option.

Important Considerations:

• Surgery is a last resort: It’s only considered after exhausting all non-surgical management options.
• Individualized approach: The decision for surgery depends on the location and severity of the complications, as well as the patient’s overall health and functional limitations.
• Focus on preserving mobility: Whenever possible, surgical techniques aim to minimize fusion and preserve flexibility in the spine.
• Long-term management: Even after surgery, spondyloarthritis itself will still require ongoing medical management.

Conclusion:

Surgery for spondyloarthritis is a complex decision with limited applications. If you and your doctor are considering surgery, it’s crucial to weigh the potential benefits against the inherent risks and discuss alternative treatment options thoroughly.

Benefits of Surgical Treatment:

Surgical intervention for spondyloarthritis can offer significant benefits, including pain relief, improved mobility, and stabilization of the spine and affected joints. By addressing underlying structural issues, surgery can help restore function and enhance the patient’s overall quality of life.

Recovery Period:

The recovery period following surgical treatment for spondyloarthritis varies depending on the specific procedure performed and individual patient factors. Patients may experience temporary discomfort, stiffness, and limitations in mobility immediately following surgery, but with proper rehabilitation and adherence to postoperative instructions, most can expect gradual improvement over time.

Rehabilitation:

Rehabilitation plays a crucial role in the recovery process after surgery for spondyloarthritis. Physical therapy, occupational therapy, and other rehabilitation techniques can help patients regain strength, flexibility, and function, as well as learn strategies to manage pain and prevent further complications.

Choosing The Southwest Scoliosis and Spine Institute:

Patients with spondyloarthritis should consider The Southwest Scoliosis and Spine Institute for their comprehensive approach to spinal care. Led by esteemed spine surgeons Doctors Richard A. Hostin, Devish Ramnath, and Ishaq Syed, the institute offers state-of-the-art facilities and personalized treatment plans tailored to each patient’s unique needs. With offices conveniently located in Dallas, Plano, and Frisco, Texas, patients can access expert care close to home. Additionally, the institute’s commitment to innovation, patient-centered care, and successful outcomes makes it the premier choice for individuals seeking relief from spondyloarthritis and other spinal conditions.

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American College of Rhumatology: Spondyloarthritis