A small percentage of people with long-standing spondylitis may go on to develop rare, but serious complications. This is one of the reasons why it is important for everyone with spondylitis to be checked by a rheumatologist at least once a year. That way, any potentially threatening complications can be caught early and treated before permanent damage has occurred.
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Rarely, people with advanced ankylosing spondylitis (AS) may have problems resulting from the scarring of the bundle of nerves at the base of the spine, called cauda equine syndrome. This condition can have a significant impact on a person's quality of life, and can cause urinary retention and/or incontinence, loss of bowel control, sexual dysfunction, and problems causing pain and weakness of the legs. If you have long-standing AS and are suffering with some of these symptoms, your rheumatologist will be able to refer you to a neurologist for consultation.
A small number of people with spondylitis display signs of chronic inflammation at the base of the heart, around the aortic valve and origin of the aorta (i.e., the vessel that takes blood from the heart to be distributed throughout the body). Years of chronic and silent inflammation at these sites can eventually lead to heart block and valve leakage, which, in rare cases, require surgical treatment. Although recognized, these cardiac lesions are probably seen in fewer than two percent of all patients with spondylitis, and nearly always in males. The lesions are readily detectable by a physician's examination and, when necessary, cardiac testing.
Poor chest wall movement may result in decreased vital capacity. Some patients develop scarring or fibrosis at the top of the lungs which detected only by routine chest X-ray (recommended every five years unless there is a special need). Sometimes people have functional lung impairment, which means that it can take longer for colds and other upper respiratory infections to heal. Smoking is absolutely contraindicated in all forms of spondylitis.
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