Ankylosing spondylitis is a difficult and complicated orthopaedic disease in the world. Over the years, medical circles have devoted great effort to it, but so far, it is still an unconquerable mountain in human’s medical history. It has made countless patients lose family joy and suffer enough from the torture of pain. In order to get rid of the agony, many patients have asked around famous doctors and effective remedies, but no satisfying curative effect is achieved. To study the reasons, we found many patients misunderstood ankylosing spondylitis. In order that patients can have a correct look at ankylosing spondylitis, we specially invited Prof. Xiao Zhengquan of Beiya Orthopaedics Hospital to write this article. Wish it can be some help on patients.
I. Ankylosing spondylitis is no other than rheumatism
In 1950s, ankylosing spondylitis was called rheumatoid rachitis or central rheumatoid arthritis in Chinese medical circles. In recent years, following the development of medical science, people’s understanding on this disease keeps deepening and they have found it is different from rheumatoid arthritis in terms of liable age, gender and location, characteristics of pathological changes, and laboratory and examination results.
1. Rheumatoid arthritis: the peak of liable age is 30-50. Male patients outnumber female patients. Pain at small joints of four limbs is more significant. Pathologic changes feature multiple symmetric joints. Both big and small joints might be affected. Its pathology is change of synovitis. Rheumatoid nodules can be seen. Rheumatoid factor is positive. HLA-B27 is negative. There is no pathologic change on sacroiliac joint and lumbar.
2. Ankylosing spondylitis: the peak of liable age is 10-30. Male patients outnumber female patients. Chronic ongoing inflammation of sacroiliac joint and spinal joint is main manifestation, which will lead to ossification of joint ligaments and osteal stiffness of spine and large joint. Patient’s serum doesn’t contain any rheumatoid factor, whereas the positive rate of HLA-B27 is as high as above 90%. Moreover, this disease is not limited to spine, hip, knee, ankle, wrist, shoulder and other large limb joints and may affect many organs such as eyes, heart and lung. Therefore, ankylosing spondylitis should be a systemic disease which destroys immune system and bones.
The above analysis indicates ankylosing spondylitis is totally different from rheumatoid arthritis. Therefore, ILAR (International League Against Rheumatism) named this disease ankylosing spondylitis in 1963.
II. Ankylosing spondylitis is no other than an orthopaedic disease
Ankylosing spondylitis is an immune-rated systemic disease with chronic ongoing inflammation. Its early symptoms are pain of sacroiliac joint, waist, back, hip or large joints accompanied by stiff waist and back. For this reason, many people believe ankylosing spondylitis is an orthopaedic disease.
But the fact is not so. It is discovered by research that the affected tissues and organs of ankylosing spondylitis sufferers are systemic, for example: eyes, heart, lung and kidney; the positive rate of HLA-B27 is as high as 90%; the amount of immunoglobulins for some patients with ankylosing spondylitis increases and the use of immunosuppressant in clinical treatment of ankylosing spondylitis has shown effect. All of the above fact supports the view that this disease is an immune-rated systemic disease mainly manifested by skeletal pathologic changes.
III. Patient with positive HLA-B27 must have ankylosing spondylitis
Long before, medical specialists have attached importance to the family heredity of ankylosing spondylitis. In 1973, Brewerton et al obtained obvious evidence of gene elements from tissue typing of ankylosing spondylitis patients. Of 75 typical patients, 72 were found with positive HLA-B27, accounting for 96% of the total patients, 31 (51%) of the 60 patients with first degree relationship were found with positive HLA-B27, whereas in the control group of 75 patients, only 3 patients were found with positive HLA-B27, accounting for 4% of the total. The comparison result suggests that people with positive HLA-B27 have a close relation with the attack of ankylosing spondylitis. As HLA system is hereditary, just like blood group antigen, heredity is one of important reasons for the attack of ankylosing spondylitis. For people with positive HLA-B27, the incidence of this disease is about 20%. Why the rest 80% didn’t have this disease? This indicates there are other pathogenic reasons except heredity.
Positive HLA-B27 alone is not necessary to suggest ankylosing spondylitis. The enhancement of resistance for a human body doesn’t mean he/she has illness. Contrarily, wind, cold, damp and evil may invade channels and tendons, resulting in obstructed Qi and blood that will trigger disease. Therefore, under equal condition, some people with positive HLA-B27 and low resistance may be attacked by this disease.
IV. Ankylosing spondylitis can be thoroughly cured
Ankylosing spondylitis is an immune-related difficult and complicated orthopaedic disease and dubbed “living corpse” and “non-fatal cancer”. It is cruel and dead-end. It has deprived countless youngsters and adults of their youth and dragged countless families into agony and despair. By what method can we save those people who are fighting helplessly against illness?
When we opened some newspaper and magazines, we found it seems that some medical institutions have cracked this international hard nut and claimed they can thoroughly cure ankylosing spondylitis, but in fact, they are overstating the curative effect and even cheating away patients’ money. Here we can say with responsibility and good faith to patients that up till present, no drug or method in the world can thoroughly cure ankylosing spondylitis.
V. Ankylosing spondylitis is spinal lesions and needn’t systemic treatment
Some people said skeletal lesions are the main manifestation of ankylosing spondylitis, so priority shall be given to the treatment of bone disease, for example: pull farther the clearance of spinal column by traction to avoid adhesion and fusion; correct bent or distorted spinal column through operation. However, all these are temporary solutions. They are as if adding some cold water to heated boiling water. They can temporary alleviate symptoms but can’t solve the problem from the root.
Ankylosing spondylitis not only encroaches on large joints of four limbs but also affects eyes, heart, lung, kidney and many other internal organs. Related immunity examinations show positive results. Ankylosing spondylitis is a hereditary immune-related disease. It is ongoing and systemic and not a pute orthopaedic disease. Therefore, only through systemic treatment, can we “attack the problem at the root”, make all immune indexes resume normal and cure both the symptoms and the disease. This also explains why after many patients have taken much pain killer, the condition is still developed and deteriorated.
Then, is ankylosing spondylitis incurable? Can patients only hopelessly endure the torture of disease?
Beiya Orthopaedics Hospital has been committed to the research on ankylosing spondylitis. We found that in the early stage of ankylosing spondylitis, spinal motions are limited to different extent, the clearance of sacroiliac joint is unclear and slightly compact, joint clearance is widened and facet joints are normal or joint clearance is changed. In this stage, treatment can avoid spinal and joint fusion and bring laboratory and examination indexes back to normal. In late stage, treatment can eliminate pain, stop bone destruction, resume immune function and realize clinical cure.
This recovery course consists of convalescent period of immune function, bone hardening and bone bridge absorption period, bone stabilization period, and convalescent period of joint function.
Beiya Orthopaedics Hospital summarizes ten methods treating ankylosing spondylitis. We call it "4 Tonics Benefiting Du Meridian” therapy. This therapy comprises a range of characteristic treatment methods which have respective advantages, are integrated organically and treat disease from different approaches and have achieved satisfying curative effect.