Associate Professor Ye Zhewei, Department of Orthopedics, Union Hospital of Huazhong University of Science and Technology Xiao Zhang has been suffering from pain in his back and spine, hip and knee joints for many years, and always thought he had rheumatism or rheumatoid rheumatism. Recently, he felt that the spine and joints are getting stiff and painful, and went to the hospital to take X-rays and found that the sacroiliac joints have become blurred and the spine has become “bamboo-like” changes, and the doctor told him that the disease he was suffering from was actually “ankylosing spondylitis”. The name “rheumatoid spondylitis”, “rheumatoid arthritis central” and so on. It is now considered by most scholars to be an independent disease, and is a connective tissue seronegative reactive disease. In the early stage of the disease, when the lesion is in the sacroiliac joint and lower lumbar spine, the patient feels pain and stiffness in the lumbosacral region, and may have sciatica and hip pain. The pain is relieved at rest and worsens with activity. When waking up in the morning, the lumbar region becomes stiff and is slightly relieved after activity. When the lesion progresses to the thoracic spine, back pain and girdle-like chest pain may occur. When the cervical spine is involved, neck movement is limited and eventually the entire spinal school becomes rigid. The entire course of the disease is slow, alternating between episodes and remissions, and can last for years or even decades. The x-ray lesions of ankylosing spondylitis first begin in the sacroiliac joint. Subsequently, the entire spine is invaded, usually from the lumbar spine to the thoracic and cervical spine from the bottom up. In late stages, near the anterior and lateral edges of the vertebrae, bony bridges are formed connecting the upper and lower vertebrae, resembling the appearance of bamboo joints, hence the name “bamboo spine”. Now, due to medical advances, most patients with ankylosing spondylitis can be diagnosed and treated early, and the incidence of the bamboo spine has decreased significantly. The following are some of the symptoms of ankylosing spondylitis in young people between the ages of 16 and 25, especially in young men. (1) Low back pain and lumbar stiffness for more than 3 months, which cannot be relieved by rest. (2) Unilateral or bilateral sciatica without a history of significant trauma or sprain. (3) Recurrent episodes of knee or ankle swelling and pain, joint effusion, without obvious history of trauma or infection. (4) Recurrent episodes of heel node swelling and pain or heel pain. (5) Recurrent episodes of iritis. (6) No cough or other respiratory symptoms, chest pain and girdling sensation without a history of trauma, and limited thoracic movement. (7) Spinal pain, stiffness, and even limited movement function without significant history of trauma or sprain. (8) Bilateral hip and hip pain with no obvious history of trauma or strain. (9) Sudden onset of pain, swelling, and activity dysfunction in large joints of the spine and extremities. The diagnosis of ankylosing spondylitis should be treated systematically and comprehensively as soon as the diagnosis is made, given that ankylosing spondylitis can stay at any one time and the disease may last for decades. There are three aspects of treatment: i. Physical therapy and physical exercise Physical therapy and physical exercise Patients with ankylosing spondylitis should sleep in a hard bed in a supine position. If the disease invades the inverted thoracic and cervical spine, the pillow should be stopped. Commonly used physical therapies include magnetic therapy, audio therapy, short wave, and heat therapy. Physical therapy should be performed under the guidance of an experienced physical therapist, and traction massage therapy for kyphosis should be added when the kyphosis exceeds 20°-40°. Physical exercise can improve respiratory function, prevent muscle atrophy, maintain bone density and strength, and prevent osteoporosis. II. Drug treatment (a) non-steroidal anti-inflammatory and analgesic drugs These drugs have a faster onset of action and can control pain in a short period of time, and are the most widely used drugs. Commonly used varieties include sodium diazepam, sulforaphane, ibuprofen, etc. Their common side effects are gastrointestinal adverse reactions. There are selective cyclooxygenase II inhibitors have a higher safety for the digestive tract. (B) Chronic-acting drugs Commonly used are salazosulfapyridine, methotrexate, etc. These drugs have a slow onset of action and take about 3 months to take effect, so they are called chronic-acting drugs. The application of these drugs can slow down or stop the development of the disease, its side effects are also more, in addition to gastrointestinal reactions, can also cause leukopenia, rash, etc., should be used under the guidance of a doctor, allergic to sulfa drugs, forbidden to sulphasalazine. (c) Chinese medicine Chinese medicine considers ankylosing spondylitis to be a paralysis category. After the disease is controlled and stabilized, Chinese medicine can be used to consolidate the therapeutic effect. (iii) Surgery Surgery is the main cause of disability in patients with ankylosing spondylitis due to spinal deformity and peripheral joint involvement resulting in narrowing or loss of joint space or joint ankylosis. Surgical treatment does not treat the root cause of ankylosing spondylitis. The main goal is to improve the function of patients so that they can live on their own and improve their quality of life. Artificial joint replacement is the best treatment for people with joint flexion, contracture, deformity, loss of function and lifelong disability to restore their ability to live and work normally. The existing indications for surgery for ankylosing spondylitis are: 1. spinal orthopedic surgery for patients with severe spinal deformities (e.g., thoracic and cervical osteotomy); 2. arthroplasty or arthroplasty for those with significantly limited hip and knee movement; and 3. valve replacement for a small number of patients with severe heart valve closure insufficiency.