Spondylitis is a chronic inflammatory disease that affects the spine and sacroiliac joints, causing pain, stiffness, and fusion of the bones. It is caused by the immune system attacking the joints, resulting in inflammation and excessive bone growth. Common symptoms include back pain that worsens in the morning and with activity. Diagnosis involves blood tests, X-rays, and imaging to detect changes in the bones. While there is no cure, treatment focuses on reducing inflammation and pain through medications, physical therapy, exercise, and sometimes surgery.

1. Dr Md Shamshir Alam, PhD
Associate Professor
MM College of Pharmacy
Mullana-Ambala, India

2. • Previously known as Bechterews disease, OR, Bechterews
syndrome OR, Marie Strumpell.
• Spondylitis means inflammation in the spinal bones,
or vertebrae.
Introduction

3. • Spondylitis is a term that refers to a set of chronic arthritis-like
disorders that affect the spine and sacroiliac joints.
• Spondylitis is an autoimmune disease in which the immune system
assaults the joints, resulting in inflammation, bone fusion, and
excessive bone growth.
• It affects the spine's joints as well as the sacroiliac joint in the
pelvis, resulting in spine fusion
• Joint inflammation can cause bones to fuse together and generate
excessive bone growth in the spine. Excessive curvature of the
spine can occur in severe situations.

4. • Complete fusion results in a complete rigidity of the spine ,
this condition is called as bamboo spine.
• Generally Spondylitis involves younger group of people,
aged 18-30 years.
• Men are affected more than women at a ratio of 3:1

5. Spondylitis: Traditional classification
1. Ankylosing spondylitis
2. Reactive arthritis
3. Psoriatic arthritis
4. Enteropathic Arthritis
5. Juvenile spondyloarthritis
6. Undifferentiated spondyloarthritis

6. • The cause of spondylitis is unknown, but a tendency to
develop the condition maybe genetic.
Causes of spondylitis

7. Signs and Symptoms
• Mild to severe back and buttock pain that often worsen in the early
morning hours.
• This pain usually gets better with activity.
• There is continued inflammation of the:
• Ligaments
• Tendons
• Joint capsules (soft tissues surrounding the joint)
• And the joint of the spine

8. • Cause the spine to fuse together together a the joints and disc spaces
are replaced by bone leading to decreased motion in the neck and low
back.
• As the spine fuses or stiffens
- the neck and the low back lose their normal curve,
- the mid-back curves outward
- and a fixed bend– forward position can result
- leading to significant disability

9. • Inflammation of the small joints joining the ribs and collarbone to the
breastbone
- cause less expansion of the chest wall with breathing.
Another common symptom is generalized fatigue.

10. Diagnosis
• There is no specific test to diagnose spondylitis.
• Blood test is done for the detection of HLA-B27 gene.
• X-ray show characteristic spinal changes.
• Tomography and magnetic resonance imaging of the sacroiliac joints
but the reliability of tests is still unclear.
• Schobers test– a useful clinical measure of flexion of the lumber spine
performed during examination.

11. • There is no cure for spondylitis but medication and exercise can ease
pain and help keep the back strong.
• Treatments and medications are available to reduce symptoms and pain
.
Treatment

12. Medication therapy
There are three major types of medications used for spondylitis:
ANTI-INFLAMMATORY DRUGS
• Includes NSAIDs such as aspirin, ibuprofen, phenylbutazone,
indomethacin, naproxen, and COX-2 inhibitors which reduce
inflammation and consequently pain.
DMARDs (Disease modifying antirheumatic drugs)
• Such as cyclosporin, methotrexate, sulfasalazine, and corticosteroids
• Reduce the immune system response through immunosuppression
effects.

13. Anti-tumor necrosis factor (TNF) medication
• Drugs like etanercept, infliximab and adalimumab (also known as
biologics).
• Indicated for the treatment and are effected immunosuppressants and
in other autoimmune disease.
• It has also been shown to be most promising treatment ,slowing the
progress of spondylitis in the majority of clinical cases.
• They have been shown to be highly effective in treating not only the
arthritis of the joints but also the spinal arthritis associated with
spondylitis.

14. Physical therapy
• To increase and maintain spine flexibility, physical therapy may
include massage and spinal manipulation.
• Exercise to relieve joint stiffness and pain.
• Exercising the lungs to ensure proper chest expansion

15. Surgical Management
• May include osteotomy for marked deformities of the hip/spine.
• In this a section of spinal bone is cut and removed to allow for
correction of spinal alignment.
• Occasionally, hip or knee arthroplasty is used, if there is severe
arthritis of those joints.