What is Bamboo Spine: Causes, Diagnosis, Treatment

Bamboo spine is a complication of ankylosing spondylitis, which is a chronic inflammatory condition. People with a bamboo spine have the spine fused into a long bone.

Adults have 24 vertebrae from the neck to the lower back. These are present one on top of the other and are known as the spinal column. Usually, the bones move independently and are flexible. In the bamboo spine as the bones fuse they get rigid and movement gets difficult.

This condition can lead to symptoms that worsen over time. The symptoms include:

• Difficulty with movement
• Back pain
• Reduced flexibility

A bamboo spine is different from a healthy spine as it is much less flexible. A healthy spine has a slight S shape that helps in withstanding pressure and distributing body weight evenly. The bamboo spine makes the vertebrae more vulnerable to stress and spinal fractures.

The bamboo spine develops as a result of calcification. In ankylosing spondylitis, the tissues connected to the bones and ligaments get inflamed repeatedly. This leads to scarring and the formation of extra bone. This extra bone fuses the vertebra joining them. This prevents the movement of vertebrae independently. This gradually affects a large portion of the spine and is termed as bamboo spine.

Bamboo spine is a complication of ankylosing spondylitis. Why ankylosing spondylitis occurs is not clear. However, it is believed that a genetic marker, HLA-B27 present in those with ankylosing spondylitis increases the risk. Scientists think that 9-10% of people with ankylosing spondylitis have this genetic marker.⁽¹⁾ Also, more than 60 other genes have links to ankylosing spondylitis.⁽²⁾ These include:

• ERAP 1
• IL-12
• IL-17
• IL-23

A physical examination is done to check the flexibility of the spine. As the bamboo spine affects the way a chest expands, the doctor may ask the person to take deep breaths and compare chest expansion to the normal one. The doctor may take the medical history and ask questions to identify symptoms of ankylosing spondylitis. If any evidence f bamboo spine or ankylosing spondylitis is detected X-ray and MRI scans are recommended.

According to the Spondylitis American Association, the treatment of ankylosing spondylosis include:

• Physical therapy that may help in increasing strength and flexibility
• Nonsteroidal anti-inflammatory drugs that can reduce pain, inflammation, and stiffness
• Heat and cold therapy
• Education

Surgery is recommended if the pain is severe or if someone is not able to hold their head up or eat and drink due to stiffness of the spine. Surgery is also recommended in case of an unstable spinal fracture.

The procedures involved in the surgery are:

Spine Osteotomy: This involves opening and straightening of the vertebrae. Rods may be inserted to fuse the remaining bones in a better position with a procedure called spinal fusion.

Laminectomy: In this procedure, a part of the spine known as the lamina is removed to create space for the spine to straighten.

Hip Replacement: This procedure involved removing the entire hip joint and replacing a prosthetic hip. Those with long-time ankylosing spondylosis are more in need of hip replacement.

Osteoporosis is the main complication of ankylosing spondylosis therefore treatment may be needed to increase bone strength and reduce the risk of fractures.⁽³⁾ The treatment includes:

• Bisphosphonates that help in maintaining bone density
• Selective estrogen receptors modulators that help in maintaining bone density and reducing the risk of fractures
• Parathyroid hormones that help in stimulating the production of new bone cells

Bamboo spine is a complication of ankylosing spondylosis, which involves fusion of the spine bones affecting its shape and flexibility. This makes the spine fragile and also reduces its movement. Early treatment of ankylosing spondylolysis can be helpful in preventing its occurrence.

People with the bamboo spine can go ahead with surgery or physical therapy to reduce the symptoms and improve their quality of life.