Ankylosing spondylitis (AS) is a chronic, painful, inflammatory arthritis that mainly affects the spine and sacroiliac joints (SIJs). It eventually causes the sacroiliac joints and spine to fuse.

X-rays show changes in the bones and joints but not until the disease has progresses. It can be up to 10 years after the start of the disease that changes are seen on the X-ray. By that time, it may be too late to change the pattern.

Humans are born with more vertebrae than they end up with later in life. Infants have 33, but some fuse together throughout childhood, leaving adults with 24. Some adults do have an extra vertebrae for a total of 25. The back is divided into the cervical spine (seven vertebrae), thoracic spine (12 vertebrae), lumbar spine (five vertebrae).

John R. Dimar II, MD, et al. Identification and Surgical Treatment of Primary Thoracic Spinal Stenosis. In The American Journal of Orthopedics.

The spine is divided into several sections: the neck and uppermost part is the cervical spine, the mid-back is the thoracic spine, the lower back is the lumbar spine, and the bottom part is the sacral area.

Two professors of medicine offer five key questions to consider when evaluating patients for ankylosing spondylitis (AS). Making an early diagnosis is important in developing a plan of care that will control symptoms. But making the diagnosis early can be a challenge because hallmark signs of AS seen on X-rays don't show up for seven to 10 years. These five questions can help doctors stay alert to the possibility of AS:

Although both forms of treatment involve poking the muscles, the actual treatment method, approach, and philosophy are very different. Acupuncture is an ancient form of Chinese medicine. Thin, tiny needles are placed in specific points along an invisible line called a meridian.

A trigger point (TrP) is an area of hyperirritability within a taut band of muscle. When pressed or palpated these points create a pattern of local and referred pain. Referred means the pain occurs at quite a distance from the points of local tenderness.

Yes, if there is heavy pressure and/or prolonged pressure on the nerve roots in the spine, it is entirely possible that the nerves become permanently damaged. If, however, the problem is removed as soon as possible, there is a chance that some recovery occurs.

Alex Gitelman, MD, et al. Cauda Equina Syndrome: A Comprehensive Review. In The American Journal of Orthopedics. December 2008. Vol. 37. no. 11. Pp. 556-562.

If you've ever suffered from chronic (day in and day out) neck, back, shoulder, or other muscle pain, you may have tried trigger point therapy. Needles are placed in painful areas of the muscles. Then a numbing agent and/or inflammatory drug such as steroids is injected at that spot. This treatment technique is the form of treatment we call trigger point therapy. Some people swear by it. Others receive little or no apparent benefit.

It's always a good idea to make sure you feel comfortable with your surgeon. This means asking questions that may help you make your decision.

Any type of surgery has its risks, back surgery is no different. If you have a surgery for a herniated, or slipped, disc, the risks involve a bit more than if you were having surgery on your knee though.