Inflammatory Conditions

Inflammatory causes, such as rheumatoid arthritis and ankylosing spondylitis

A group of arthritic conditions may cause an inflammatory process in the spine which may lead to tissue damage and destruction. Ankylosing spondylitis is one such condition. The condition is more common in males and often commences in late teens and early twenties. The typical symptoms are of back pain and stiffness, which is usually worse in the mornings. The patient may find that a hot shower gives some relief. Movement is difficult but gets easier with activity. In serious cases, the whole spine may become inflamed and stiffens. Eventually this may lead to a “bamboo spine” with no motion at any level. The spine is brittle as it is more prone to fractures following injury. The patient can end up with a severe deformity with a flexed posture and in some cases the patient is unable to look ahead, so severe is the deformity. Blood tests may provide some clues. The ESR (erythrocyte sedimentation rate) can be elevated. The HLAB27 test may be positive.

X ray of the neck and showing a rigid 'bamboo spine'
Fig. 15
X ray of the neck and showing a rigid 'bamboo spine'
Fig. 16

Fig 15 & 16 The X ray is of the neck and shows a rigid "bamboo spine". There is loss of distinction of the discs so that the vertebral bodies seem to merge into each other. The patient has had a minor fall and this has resulted in a broken neck as further shown on the MRI image.

The treatment in the early stages is of physiotherapy and hydrotherapy. Non-steroidal anti-inflammatory medication may bring symptomatic relief. The condition should be managed by an expert in the area (Rheumatologist).

Rheumatoid arthritis is another inflammatory joint disease which can often affect the spine. This condition is more common in females. The joints are damaged by the process and these can allow deformities to develop.

Rheumatoid arthritis is another inflammatory joint disease which can often affect the spine. This condition is more common in females. The joints are damaged by the process and these can allow deformities to develop.

X ray of the neck and showing a rigid 'bamboo spine'
Fig. 17: Rheumatoid arthritis 1992
X ray of the neck and showing a rigid 'bamboo spine'
Fig. 18: Rheumatoid arthritis. Same patient but in1997. There has been some deterioration in the alignment of the vertebrae due to inflammatory damage to the spine.
X ray of the neck and showing a rigid 'bamboo spine'
Fig. 19: Rheumatoid arthritis. Same patient as in figs 17 and 18 in 2006. Surgery was required to restore the alignment of the neck.

We specialise in assessment and diagnosis of spinal complaints with appropriate conservative treatment, planning surgery only when all other options have been exhausted.