Ankylosing Spondylitis: It is an inflammatory rheumatic disease that causes movement restriction in the spine. With the ossification of the ligaments that provide flexibility to the spine due to the disease, the spine is fixed as if it was plastered. This causes restriction in waist and neck movements and hunching forward.
In more advanced stages, with severe limitation of neck movements, the head cannot move, the field of view narrows, and the person can only direct his head by turning his whole body. Symptoms begin before the age of 40, especially in the 20s. There is no definitive treatment, but it is possible to reduce complaints and prevent disability with treatment. Here we present a case of ankylosing spondylitis.
Case: A 35-year-old male patient. The patient, who has been followed up with the diagnosis of ankylosing spondylitis for 10 years, has widespread low back and hip pain. (VAS 9-10) This patient has limitation of movement due to ankylosing spondylitis and 10 cm between the ground and the head when lying down. range remains. He went to various polyclinics for these complaints and could not get a response. Thereupon, she applied to the algology outpatient clinic. Here, we recommended the patient to continue the previous medical treatment (TNF Blocker) during the treatment. We first performed a caudal epidural block for our patient for widespread pain and 15 days later
we called her for a control. On control, the VAS was 7-8. Thereupon, we gave our patient a sacroiliac joint injection to the previous block and called for control 15 days later. On control, the VAS was 4-5. Thereupon, paracervical and lumbar-trocal paravertebral blocks were added in addition to the previous two blocks and he was called for control 15 days later. In the control, the VAS was 3-4. Then, suprascapular block was added with the previous three blocks and he was called for control 15 days later. On control, the VAS was 1-2, his movements were very relaxed, and the head-to-floor gap decreased to 0 cm when he lay down. Thereupon, the interventional procedures were terminated to repeat the previous 4 blocks and come to the control 3 months later
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Conclusion: Interventional blocks have an important role in the treatment of pain caused by ankylosing spondylitis, relaxation of movements and improving quality of life. We think that this effect is due to the increase in parasympathetic activity with sympathetic blocks, which are caused by the blocks, and as a result of vasodilation and revascularization.
