Does ankylosing spondylitis require surgery?

Most patients with ankylosing spondylitis do not require surgical intervention; those with mild disease or in the stable phase can effectively control their condition through medication and rehabilitation exercises. Surgery is reserved only for patients in the late stages of disease who have developed severe joint deformities. Prompt medical evaluation and treatment planning are essential when spinal mobility becomes severely restricted or joint deformities worsen.

The cornerstone of treatment for ankylosing spondylitis is conservative management. During early disease—characterized by low back stiffness and inflammatory joint flares—anti-inflammatory and immunomodulatory medications are used to suppress inflammation, complemented by regular rehabilitation exercises to preserve spinal and joint mobility. With long-term, standardized conservative therapy, most patients can effectively slow disease progression, prevent structural damage, and maintain normal daily functioning and physical activity capacity.

In advanced disease, when severe spinal rigidity, kyphotic deformity, or hip joint fusion significantly impair bodily function, surgical correction may be considered to restore joint mobility and correct deformities. However, surgery cannot cure the disease; postoperative pharmacotherapy and continued rehabilitation remain essential to control chronic systemic inflammation and prevent further disease progression.

In daily life, patients should regularly perform spinal stretching and chest-expansion exercises to maintain joint flexibility. Adopting proper posture and maintaining consistent sleep-wake routines help stabilize overall physical condition and slow the progression of spinal and joint pathology.