What are the late-stage manifestations of ankylosing spondylitis?

In general, when ankylosing spondylitis progresses to its late stage, the pathological changes can severely affect the function of the spine and surrounding tissues. Typical manifestations mainly include complete restriction of spinal movement, severe spinal deformity, involvement of peripheral joints, compression of thoracic and abdominal organs, and loss of ability to perform daily activities. A detailed analysis is as follows:

1. Complete restriction of spinal movement: In the late stage, extensive ossification and fusion of intervertebral ligaments and discs cause the spine to lose its normal mobility. Patients are unable to perform basic movements such as bending over, turning around, lifting up, or lowering their head. The spine becomes rigid like a single unit, and changes in body direction can only be achieved by rotating the entire trunk.

2. Severe spinal deformity: Long-term inflammation and vertebral fusion may lead to significant spinal deformities. The most common is kyphotic deformity, characterized by a prominent hump on the back, forward tilting of the head, chest curvature forward, and inability to maintain an upright posture. Some patients may also develop scoliosis, with the spine curving to one side.

3. Involvement of peripheral joints: Besides the spine, peripheral joints in late-stage patients may also develop severe lesions, such as hip joints, knee joints, and shoulder joints. These joints may exhibit obvious swelling, pain, narrowing of joint space, or even fusion, resulting in restricted joint movement. Patients may experience limping while walking, and actions such as climbing stairs or standing up from a seated position may require external assistance.

4. Compression of thoracic and abdominal organs: Severe kyphotic deformity of the spine can compress the space within the thoracic and abdominal cavities, affecting the function of organs located within. Thoracic compression may restrict lung expansion, causing symptoms such as dyspnea, chest tightness, and shortness of breath, which are particularly noticeable after physical activity.

5. Loss of daily activity ability: Affected by the above symptoms, patients in the late stage may completely lose their ability to perform daily activities, being unable to dress, wash, eat, or use the toilet independently. Their lives become entirely dependent on others. Additionally, long-term bed rest or restricted movement may lead to complications such as pressure ulcers, pulmonary infections, and muscle atrophy.

In late-stage cases, patients need assistance from family members to maintain proper posture, regularly turn over, and exercise limbs to prevent complications. Under a physician's guidance, appropriate rehabilitation training may also be conducted to help preserve existing limb function and improve quality of life.