Most patients with ankylosing spondylitis (AS) can be treated conservatively without surgery. Surgery may be the best option for anyone who is bent so far forward the chin rests on the chest. Patients who can no longer look up to see where they are going or who can't lie down flat are also likely candidates for surgery.

Several surgical options are available. The type of procedure used depends on the condition of the spine, presence of nerve pressure, and age. Older patients have less flexible blood vessels. Surgery to change the angle of the spine and straighten the patient also straightens large arteries such as the aorta. Rupture of the aorta or its branches can occur. The risk is small but it can happen.

Usually straightening other structures such as the gastrointestinal tract is possible because the organs are soft and moveable. The lungs and stomach respond well to the reduced pressure and room to move and "breathe" so-to-speak.

It would be good to bring this question up with his surgeon. He or she will explain the type of operation planned and any steps that may be needed. Risks and complications will be reviewed, too. Don't hesitate to ask questions and express your concerns during the doctor visit.