Ankylosing Spondylitis Surgery: What You Should Know

Most times, ankylosing spondylitis (AS) — a type of inflammatory arthritis — can be effectively treated with medication and physical therapy. But occasionally, surgery may be needed.
Here’s what to know about when AS surgery may be warranted, types of AS surgery, and more.
When Is Ankylosing Spondylitis Surgery Needed?
“In most cases, orthopedic surgeons will perform surgery in AS patients to stabilize fractures,” says Michael Gerling, MD, an orthopedic spinal surgeon in New York City.
You may need surgery if severe AS pain doesn’t improve enough with medications or exercise, or when spinal pain comes with persistent neurological symptoms like numbness or, in more serious cases, weakness, loss of motor function, or loss of bowel or bladder control, Dr. Gerling adds.
Here are some instances when you and your doctor may want to consider surgery.
Kyphosis
Spinal Fracture
Severe Hip Joint Damage
Spinal Cord Injury
Types of Ankylosing Spondylitis Surgery
The type of surgery you need for AS may depend on your symptoms or, if you’ve been injured, the type of injury you have.
Laminectomy
Osteotomy
- Closing-Opening-Wedge Osteotomy (COWO) Removal and placement of bone material at various places along the spine to correct curve abnormalities
- Poly-Segmental Wedge Osteotomy (PWO) Removal of bone at several points along the spine to correct over-curvature
- Monosegmental Closed-Wedge Osteotomy (CWO) Curve correction through surgery on one vertebra, or back bone
Fusion
Hip Replacement
Risks and Side Effects of Ankylosing Spondylitis Surgery
- Anesthesia-related complications
- Infection
- Excessive bleeding
How Successful Is Ankylosing Spondylitis Surgery?
AS surgery success depends on many factors, like your health at the time of surgery and the type of surgery you have. In general, people with AS are more likely to have optimal results if they’re up for the post-op recovery period. “[They] want to be in good enough shape to rehab after a surgery,” says Cohen. “You need to have enough muscle strength and health to recover.”
The Takeaway
- AS can usually be managed through medication and physical therapy, but occasionally, it can require surgery.
- Options like laminectomy, osteotomy, spinal fusion, and hip replacement each offer different benefits, but also carry certain risks.
- Talk with your healthcare provider to see if surgery might be the next step for your AS management.
Resources We Trust
- Cleveland Clinic: Ankylosing Spondylitis
- Mayo Clinic: Ankylosing Spondylitis: Diagnosis & Treatment
- Weill Cornell Medicine: Surgery for Ankylosing Spondylitis
- National Institute of Arthritis and Musculoskeletal and Skin Diseases: Ankylosing Spondylitis: Diagnosis, Treatment, and Steps to Take
- Spondylitis Association of America: Treatment of Spondyloarthritis

Alexa Meara, MD
Medical Reviewer
Alexa Meara, MD, is an assistant professor of immunology and rheumatology at The Ohio State University. She maintains a multidisciplinary vasculitis clinic and supervises a longitudinal registry of lupus nephritis and vasculitis patients. Her clinical research is in improving patient–physician communication. She is involved in the medical school and the Lead-Serve-Inspire (LSI) curriculum and serves on the medical school admissions committee; she also teaches multiple aspects of the Part One curriculum. Her interests in medical-education research include remediation and work with struggling learners.
Dr. Meara received her medical degree from Georgetown University School of Medicine in Washington, DC. She completed her internal medicine training at East Carolina University (ECU) at Vidant Medical Center in Greenville, North Carolina, then spent two more years at ECU, first as chief resident in internal medicine, then as the associate training program director for internal medicine. She pursued further training in rheumatology at The Ohio State University in Columbus, completing a four-year clinical and research fellowship there in 2015.

Abby McCoy, RN
Author
Abby McCoy is an experienced registered nurse who has worked with adults and pediatric patients encompassing trauma, orthopedics, home care, transplant, and case management. She is a married mother of four and loves the circus — that is her home! She has family all over the world, and loves to travel as much as possible.
McCoy has written for publications like Remedy Health Media, Sleepopolis, and Expectful. She is passionate about health education and loves using her experience and knowledge in her writing.
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