New Medical techniques brings ray of hope for patients with rheumatological Disorders of the Spine

Rheumatological disorders of the spine are a kind of disease where your own immune system, instead of protecting you, starts attacking it your spine. It's a process of self destruction in which the auto-antibodies produced by the body's own immune system act against the spine, destroying the proteins and molecules located inside the bones, joints, inter vertebral disc (IVD) and muscles of the spine.

The result is permanent destruction of the joints, which can cause deformity of the spine (spondylitis).

Its symptoms can range from fatigue, redness, inflamed or stiff joints and high fever.

This process of self destruction starts at a very young age, causing early and rapid inflammatory degeneration of the connective tissues in the body, which results in rapid ageing and spondylitis of the vertebral column. Thus rheumatological diseases of the spine are also sometimes called connective tissue disorders.

 The majority of the changes caused by this autoimmune destruction of the connective tissues of the vertebral column are irreversible, leading to permanent loss of function and stiffness of the back bone. This condition was once thought to be incurable and the patient had to live with a permanent disability for rest of their life. Considering the very young age of these patients and high incidence and prevalence of these rheumatological disorders, the quantum or magnitude of these connective tissue diseases and its psycho-socio-economic impact on the patients and family's life is immense and often underestimated.

Rheumatological disorders lead to immense loss of working capability in young people and thus pose a great economic burden to society, by lowering economic productivity. The classically available treatment options are very expensive, thereby adding to the financial burden, and they are also not very effective in curing the condition permanently. At best, they are able to provide some incomplete, temporary symptomatic relief for a brief duration of time.


There are different forms of rheumatoid diseases. Among these, rheumatoid arthritis is the most common. It occurs more frequent in females and typically starts in the early twenties. It progresses rapidly, causing gross destruction and deformity of all the major joints by the fourth decade of life. One more common rheumatological disease is Reiter syndrome, which affects the vertebral column. This condition is more common in males and typically begins in the teenage years. Another disorder called ankylosing spondylitis is typically more common in males and starts in the early twenties. The back bone becomes grossly deformed with forward bending or kyphosis of the whole spine. This condition can also result in the formation of a rounded hump called "kubad", which makes it extremely difficult for the patient to walk. Then there is soft tissue rheumatism, which is common in women and starts in the early twenties. Similarly, there are many other forms of rheumatoid conditions, which manifest in men and women differently, at different ages.


Traditionally, treatment of almost all rheumatological diseases started with strong anti-inflammatory medicines. To add to the potency, enzymes were are also given. Doctors further administered long acting steroids in the form of pulse therapy, in short intermittent periods. Additionally, disease modifying drugs (DMDs) were given on a continuous basis. All of these have not been able to permanently cure the condition, and offer only symptomatic treatment. But there is now new hope for the patients. New chemotherapeutic drugs introduced early in the course of the disease are known to give long term remissions and control the progression of these rheumatological disorders. Further, specific targeted gene therapy in ankylosing spondylitis patients with defective genes gives these patients some amount of control over the progression of their condition and the associated loss of function. Similarly, a new technique by the name of immunomodulation (cytokines and leucotrienes), which specifically targets immunotherapy against antinuclear antibodies and double stranded DNA antibodies, help destroy these auto antibodies that damage the joints. Immunomodulation can regulate the body's immune system and prevent damage from harmful antibodies. Further, certain regenerative medicines that are available can help with the regeneration or reformation of the damaged cartilage and degenerated intervertebral disc (IVD) leading to reversal of the disease process. Autologous bone marrow stem cell transplant is another effective treatment.


In case the above measures are not effective, the option of surgery does exist. Minimally invasive surgery in the form of key hole or endoscopic surgery using a gamma knife, cold diode and carbon dioxide lasers can be used.