What is Ankylosing Spondylitis?

Ankylosing spondylitis (AS) is one of the many types of arthritis. “Ankylosing” means joining together or stiffening; “spondylitis” means inflammation of the vertebral bones of the spine. Inflammation of the bones in AS can lead to degeneration, pain, and loss of joint motion. AS typically affects the spine but can be seen in other areas, especially the hips. Ankylosing spondylitis can range from a mild to more severe disease in patients.

Ankylosing spondylitis is approximately three times more common in males than females. It is usually diagnosed in young adults, with a peak onset between 20 and 30 years of age. Children may also be affected by a form of AS termed “juvenile ankylosing spondylitis”, seen in children younger than 16 years of age.

There is evidence suggesting a strong genetic component in the development of the disease. Those with a family history of AS involving a first-degree relative (i.e. mother, father, siblings) will be 5 to 16 times more likely to develop AS.

Sciatica is a painful condition that affects the lower back and the leg. When the sciatic nerve becomes irritated, sciatica leads to pain that is typically felt on just one side of the body. Sciatica is also known to cause numbness in the affected regions of the body, as well as trouble with controlling the leg.

Sciatica Nerve
When a person has sciatica, pain radiates from the lower back down to the thigh, extending downward to the back of the calf. In some cases, pain from sciatica flows upward as well, affecting the hip, and back down toward the foot. For many affected individuals, pain from sciatica is enough to impair the performance of everyday tasks.

Anatomy Of Sciatica
As the largest nerve in the human body, the sciatic nerve has a great range, extending from the lumbar spinal cord down through the leg. The sciatic nerve is formed from the L5 and S1 nerve roots in the spinal canal and the union of these nerves becomes the sciatic nerve in the pelvis. The sciatic nerve continues through the pelvis into the buttock and back of the upper thigh to the back of the knee where it splits into nerves coursing into the calf.

Causes Of Sciatica
One of the main causes of sciatica inflammation then is herniated discs in the lumber or sacral regions which put pressure on the sciatic nerve and result in causing pain and discomfort

Signs And Symptoms Of Sciatica

• Mild to intense pain in the buttock, thigh, calf, or foot, or in all these areas is experienced.
• If the pressure is more on the nerve, numbness will also be felt.
  The numbness, however, is not always accompanied by back pain and this can lead to sciatica being mistaken for a pulled muscle.
• If one experiences numbness, a feeling of pins and needles, and loss of bladder control along with sciatica, it requires immediate medical attention.

What Is Scoliosis?
Some degree of scoliosis may occur in severe osteoarthritis patients. It is a spinal curvature as seen from the front or back of the person who has it. Instead of being a straight shape, the spine assumes an s’ or ‘c’ shape. The curves are measured in degrees. The curve which is more than 30-degree needs to be carefully watched because it can worsen rapidly. Scoliosis is more often seen in osteoarthritis people as compared to the general population.

Anatomy Of Scoliosis
Scoliosis is an abnormal side-to-side curvature of the spine. A normal spine will have curves that run from front to back. When viewed from the back, a normal spine will appear perfectly straight. When viewed from the back, a spine with scoliosis will appear to curve to one side or both. This condition can also cause the rotation of individual vertebras in the spine.>Scoliosis is an abnormal side-to-side curvature of the spine. A normal spine will have curves that run from front to back. When viewed from the back, a normal spine will appear perfectly straight. When viewed from the back, a spine with scoliosis will appear to curve to one side or both. This condition can also cause the rotation of individual vertebra in the spine.

The curvature of the spine is measured in degrees, just like an angle. A normal spine is straight or has a curve of less than 10 degrees. Mild curvature is from 10 to 20 degrees. Moderate curvature is 20 to 50 degrees. Severe spinal curvature is measured at over 50 degrees.

Causes Of Scoliosis
Nearly 80-85% of scoliosis are idiopathic, which means the cause cannot be identified. The causes of scoliosis may be structural or functional. There are a few known causes of scoliosis which include birth defects, tumors, and injury.

CAUSES OF FUNCTIONAL SCOLIOSIS
When the spine is structuring normally but it appears curved because of another cause is called functional scoliosis. Such type of scoliosis is often caused by an underlying condition such as

• If there is a difference in the length of the leg
• Muscle spasms or
  An inflammatory condition such as appendicitis.

CAUSES OF STRUCTURAL SCOLIOSIS The spine curvature is abnormal in structural scoliosis. It may be due to unknown factors Birth defects, Injury, Certain Infections, Tumors, Rheumatic disease, Neuromuscular disease(such as polio, muscular dystrophy, and cerebral palsy), or Connective tissue disorders

Symptoms Of Scoliosis
Scoliosis is usually painless. Scoliosis usually doesn’t cause pain or limit a child’s movements, so it is easily overlooked. Most children receive a diagnosis during a routine physical. Still, alert parents can often spot early warning signs:

• A tilted head that does not line up over the hips
• A protruding shoulder blade
• One hip or shoulder is higher than the other, causing an uneven hem or shirt line
• An uneven neckline
• Leaning more to one side than the other 6) In developing girls, breasts appear to be of unequal size
  One side of the upper back is higher than the other when the child bends over, knees together, with the arms dangling down.

Diagnosis Of Scoliosis
As always, a careful history and physical examination are the first steps in the diagnosis of scoliosis. The diagnosis of scoliosis is often made on physical examination.

An X-ray of the back will show exactly where and how much the spine is curved. The doctor can make very precise calculations from the X-ray photograph to determine a measurement known as the Cobb angle. The Cobb angle combines all of the data provided by an X-ray photograph to determine the extent of a person’s scoliosis. Occasionally, magnetic resonance imaging (MRI) would be done.

Treatment Of Scoliosis

• Non-Surgical Treatment Of Scoliosis: The non-operative treatment of scoliosis involves observing the deformity with examinations and repeated x-rays. Under certain circumstances, when spinal growth remains, a brace may be used in combination with follow-up x-rays. Physical therapy exercises have not been shown to be an effective treatment for scoliosis.
• Surgical Treatment Of Scoliosis: The most common surgical treatment for scoliosis is a Spine Fusion using special stainless steel rods, hooks, and a bone graft. The rods are attached to the spine with hooks and the curved portion of the spine is carefully straightened. Then, small strips of bone graft are placed over the spine to fuse it in a straight position.

As the bone graft heals over the next several months, the spine becomes solid and will not curve again. But the part of the spine that has not been fused will still be flexible, and allow nearly normal overall movement.