Methotrexate therapy requires further study. Administration of radiation therapy to the spine was once used successfully but is no longer recommended because of the risk of subsequent malignancy. All patients with ankylosing spondylitis should be informed of potential spinal deformities and how to prevent them. Good posture should be emphasized. A firm mattress and minimal pillow support are recommended.
Swimming is a very effective means of achieving exercise goals.
Some patients who develop hip involvement, a major cause of disability, greatly benefit from total hip replacement. Wedge osteotomy for severe spinal kyphosis is available only at a few medical centers. Treatment of spinal fractures is controversial. Pregnancy does not appear to be significantly affected by ankylosing spondylitis. Prognosis for individual patients is often difficult to ascertain.