The role of lymphocyte-monocyte ratio on ankylosing spondylitis diagnosis and sacroiliac arthritis staging

Abstract Background: Ankylosing spondylitis (AS)is a chronic inflammatory disorder involving the sacroiliac joints, lumbar spine, thoracic spine and even cervical spine, and could leading to disability due to the failure of timely treatment. Therefore, early diagnosis is essential to for AS treatment. The lymphocyte-monocyte ratio (LMR) is a systemic inflammatory and immunological indicator for prediction of disease development and progression. However, its role in AS remains unclear. The aim of this study was to investigate the role of LMR in AS diagnosis, disease activity classification and sacroiliac arthritis staging. Methods: Seventy-eight AS patients and 78 sex-age-matched healthy controls (HCs) were enrolled in this study. The diagnosis of AS was performed according to the New York criteria, whereas the staging of sacroiliac arthritis of AS patients was determined by X-ray examination.Comparison of between AS patients and HCs and between patients with high and low stages on LMR levels and other laboratory indicators were carried out. Results: A higher level of NLR, RDW, PLR, MPV, ESR, CRP and lower level of RBC, Hb, Hct, LMR, ALT, AST, TBIL and A/G were noted in the AS patients compared to HCs. A positive correlation was observed between LMR and RBC, Hb, Hct and A/G, while negative correlation was found between LMR and NLR, PLR, AST, TBIL (P< 0.05). The ROC curve showed that the area under the curve of LMR was 0.803(95%CI =0.734-0.872), with a sensitivity and specificity of 62.8% and 87.2%,and the AUC (95%CI) for ESR, CRP and LMR in the combined diagnosis of ankylosing spondylitis were 0.975(0.948-1.000),with the sensitivity and specificity of 94.9% and 97.4% .Levels of WBC and NLR were higher in high X-ray stage patients, whereas levels of LMR was lower (P<0.05) and statistical differences were observed of LMR values among different stages (P<0.05). Conclusions: Our study suggested that LMR is an important inflammatory marker that can be used to diagnosis AS and identify disease activity and X-ray stage of sacroiliac arthritis in AS patients.

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The role of lymphocyte-monocyte ratio on ankylosing spondylitis diagnosis and sacroiliitis staging

10.21203/rs.2.21180/v2 ◽

2020 ◽

Author(s):

Jing Wang ◽

Jinyu Su ◽

Yuan Yuan ◽

Xiaxia Jin ◽

Bo Shen ◽

...

Keyword(s):

Ankylosing Spondylitis ◽

Blood Cell ◽

Disease Activity ◽

Sensitivity And Specificity ◽

Red Blood Cell ◽

Roc Curves ◽

X Ray ◽

Lymphocyte Ratio ◽

Asas Classification Criteria

Abstract Background: Ankylosing spondylitis (AS)is a chronic inflammatory disorder involving the sacroiliac joints, that could lead to disability due to the failure of timely treatment. Therefore, early diagnosis is essential to for AS treatment. The lymphocyte-to-monocyte ratio (LMR) is an indicator of disease progression. However, its role in AS remains unclear. The aim of this study was to investigate the role of LMR in AS diagnosis, disease activity classification and sacroiliitis staging. Methods: Seventy-eight AS patients and 78 sex and age matched healthy controls (HCs) were enrolled in this study. The diagnosis of AS was performed according to the New York criteria or the Assessment of SpondyloArthritis international Society (ASAS) classification criteria, whereas the staging of sacroiliitis in AS patients was determined by X-ray examination. Comparisons of LMR levels between groups were performed using t test. Pearson or Spearman correlation analysis were used to assess correlations between LMR and other indicators. Receiver operating characteristic (ROC) curves were used to determine the role of LMR in the diagnosis of AS.Results: Higher neutrophil-to-lymphocyte ratio(NLR), red blood cell distribution width(RDW), platelet-to-lymphocyte ratio(PLR), mean platelet volume(MPV), erythrocyte sedimentation rate (ESR), and C-reactive protein(CRP) levels and lower red blood cell (RBC), hemoglobin (Hb), Hematocrit (Hct), LMR, alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL) and albumin/globulin (A/G) levels were noted in AS patients compared to HCs. Positive correlations were observed between LMR and RBC, Hb, Hct and A/G, whereas negative correlations were found between LMR and NLR, PLR, AST, and TBIL (P< 0.05). ROC curves showed that the area under the curve(AUC) for LMR in the diagnosis of ankylosing spondylitis was 0.803 (95% CI =0.734-0.872) with a sensitivity and specificity of 62.8% and 87.2%, respectively, and the AUC (95% CI) for the combination of ESR, CRP and LMR was 0.975 (0.948-1.000) with a sensitivity and specificity of 94.9% and 97.4%, respectively. LMR levels were lower (P<0.05) and significant differences in LMR values were observed among different stages (P<0.05). Conclusions: Our study suggested that LMR could be an important inflammatory marker that can be used to diagnosis AS and identify disease activity and X-ray stage of sacroiliitis.

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Psychological Correlates of Self-reported Disease Activity in Ankylosing Spondylitis

The Journal of Rheumatology ◽

10.3899/jrheum.090476 ◽

2010 ◽

Vol 37 (4) ◽

pp. 829-834 ◽

Cited By ~ 29

Author(s):

TAMAR F. BRIONEZ ◽

SHERVIN ASSASSI ◽

JOHN D. REVEILLE ◽

CHARLES GREEN ◽

THOMAS LEARCH ◽

...

Keyword(s):

New York ◽

Ankylosing Spondylitis ◽

Disease Activity ◽

Activity Index ◽

Disease Activity Index ◽

Multivariate Regression Analysis ◽

Passive Coping ◽

Psychological Variables ◽

Psychological Measures

Objective.To investigate the role of psychological variables in self-reported disease activity in patients with ankylosing spondylitis (AS), while controlling for demographic and medical variables.Methods.Patients with AS (n = 294) meeting modified New York criteria completed psychological measures evaluating depression, resilience, active and passive coping, internality, and helplessness. Demographic, clinical, and radiologic data were also collected. Univariate and multivariate analyses were completed to determine the strength of the correlation of psychological variables with disease activity, as measured by the Bath AS Disease Activity Index (BASDAI).Results.In the multivariate regression analysis, the psychological variables contributed significantly to the variance in BASDAI scores, adding an additional 33% to the overall R-square beyond that accounted for by demographic and medical variables (combined R-square 18%). Specifically, arthritis helplessness and depression accounted for the most significant portion of the variance in BASDAI scores in the final model.Conclusion.Arthritis helplessness and depression accounted for significant variability in self-reported disease activity beyond clinical and demographic variables in patients with AS. These findings have important clinical implications in the treatment and monitoring of disease activity in AS, and suggest potential avenues of intervention.

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Serum Sclerostin as a Possible Biomarker in Ankylosing Spondylitis: A Case-Control Study

Journal of Immunology Research ◽

10.1155/2018/9101964 ◽

2018 ◽

Vol 2018 ◽

pp. 1-5 ◽

Cited By ~ 5

Author(s):

Fabio Massimo Perrotta ◽

Fulvia Ceccarelli ◽

Cristiana Barbati ◽

Tania Colasanti ◽

Antonia De Socio ◽

...

Keyword(s):

New York ◽

Ankylosing Spondylitis ◽

Disease Activity ◽

Serum Levels ◽

Healthy Controls ◽

Radiographic Damage ◽

Baseline Serum ◽

Progression Of Disease ◽

And Function

Objective. Several molecules are involved in the pathogenesis of a new bone formation in ankylosing spondylitis (AS). The aim of this study was to evaluate the serum levels of sclerostin in patients with AS as a possible biomarker and to investigate any correlations with radiographic damage, disease activity, and function. Methods. AS patients fulfilled the modified New York criteria, and healthy controls were enrolled for this study. BASDAI, ASDAS-CRP, BASMI, BASFI, patient and physician VAS, and C-reactive protein were evaluated at baseline visit. Spinal damage was assessed using the mSASSS on radiographs performed within 3 months from baseline. Serum concentrations of sclerostin were assessed at baseline and after four months of therapy in patients who started an anti-TNF. Results. Twenty healthy subjects and 40 AS patients were enrolled in the study. In our group, serum sclerostin levels (median (25th–75th percentile)) were significantly higher in healthy controls (18.04 (13.6–24) pg/ml) than in AS patients (6.46 (4.5–11.1) pg/ml; P value < 0.01). However, no significant correlations were found between serum sclerostin levels and radiographic damage, assessed by mSASSS, and between serum sclerostin levels and clinical indices of activity and disability or with laboratory parameters. Sclerostin levels did not show significant changes after 4 months of anti-TNF therapy. Conclusions. The results of our study suggest a possible role of sclerostin in the identification of AS patients. Further studies are needed to prove the role of sclerostin as a disease activity biomarker and progression of disease in AS.

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The role of lymphocyte-monocyte ratio on axial spondyloarthritis diagnosis and sacroiliitis staging

10.21203/rs.2.21180/v4 ◽

2020 ◽

Author(s):

Jing Wang ◽

Jinyu Su ◽

Yuan Yuan ◽

Xiaxia Jin ◽

Bo Shen ◽

...

Keyword(s):

Blood Cell ◽

Disease Activity ◽

Sensitivity And Specificity ◽

Red Blood Cell ◽

Axial Spondyloarthritis ◽

Roc Curves ◽

X Ray ◽

Lymphocyte Ratio ◽

Asas Classification Criteria

Abstract Background: Axial spondyloarthritis (axial SpA)is a chronic inflammatory disorder involving the sacroiliac joints, that could lead to disability due to the failure of timely treatment. The lymphocyte-to-monocyte ratio (LMR) is an indicator of disease progression. However, its role in axial SpA remains unclear. The aim of this study was to investigate the role of LMR in axial SpA diagnosis, disease activity classification and sacroiliitis staging. Methods: Seventy-eight axial SpA patients and 78 healthy controls (HCs) were enrolled in this study. The diagnosis of axial SpA was performed according to the New York criteria or the Assessment of Spondyloarthritis international Society (ASAS) classification criteria, whereas the staging of sacroiliitis in axial SpA patients was determined by X-ray examination. Comparisons of LMR levels between groups were performed using t test. Pearson or Spearman correlation analysis were used to assess correlations between LMR and other indicators. Receiver operating characteristic (ROC) curves were used to determine the role of LMR in the diagnosis of axial SpA.Results: Higher neutrophil-to-lymphocyte ratio(NLR), red blood cell distribution width(RDW), platelet-to-lymphocyte ratio(PLR), mean platelet volume(MPV), erythrocyte sedimentation rate (ESR), and C-reactive protein(CRP) levels and lower red blood cell (RBC), hemoglobin (Hb), Hematocrit (Hct), LMR, alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL) and albumin/globulin (A/G) levels were noted in axial SpA patients compared to HCs. Positive correlations were observed between LMR and RBC, Hb, Hct and A/G, whereas negative correlations were found between LMR and NLR, PLR, AST, and TBIL (P< 0.05). ROC curves showed that the area under the curve(AUC) for LMR in the diagnosis of ankylosing spondylitis was 0.803 (95% CI =0.734-0.872) with a sensitivity and specificity of 62.8% and 87.2%, respectively, and the AUC (95% CI) for the combination of ESR, CRP and LMR was 0.975 (0.948-1.000) with a sensitivity and specificity of 94.9% and 97.4%, respectively. LMR levels were lower (P<0.05) and significant differences in LMR values were observed among different stages (P<0.05). Conclusions: Our study suggested that LMR might be an important inflammatory marker to identify axial SpA and assess disease activity and X-ray stage of sacroiliitis.

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The role of lymphocyte-monocyte ratio on axial spondyloarthritis diagnosis and sacroiliitis staging

10.21203/rs.2.21180/v3 ◽

2020 ◽

Author(s):

Jing Wang ◽

Jinyu Su ◽

Yuan Yuan ◽

Xiaxia Jin ◽

Bo Shen ◽

...

Keyword(s):

Blood Cell ◽

Disease Activity ◽

Sensitivity And Specificity ◽

Red Blood Cell ◽

Axial Spondyloarthritis ◽

Roc Curves ◽

X Ray ◽

Lymphocyte Ratio ◽

Asas Classification Criteria

Abstract Background: Axial spondyloarthritis (axial SpA)is a chronic inflammatory disorder involving the sacroiliac joints, that could lead to disability due to the failure of timely treatment. The lymphocyte-to-monocyte ratio (LMR) is an indicator of disease progression. However, its role in axial SpA remains unclear. The aim of this study was to investigate the role of LMR in axial SpA diagnosis, disease activity classification and sacroiliitis staging.Methods: Seventy-eight axial SpA patients and 78 healthy controls (HCs) were enrolled in this study. The diagnosis of axial SpA was performed according to the New York criteria or the Assessment of Spondyloarthritis international Society (ASAS) classification criteria, whereas the staging of sacroiliitis in axial SpA patients was determined by X-ray examination. Comparisons of LMR levels between groups were performed using t test. Pearson or Spearman correlation analysis were used to assess correlations between LMR and other indicators. Receiver operating characteristic (ROC) curves were used to determine the role of LMR in the diagnosis of axial SpA.Results: Higher neutrophil-to-lymphocyte ratio(NLR), red blood cell distribution width(RDW), platelet-to-lymphocyte ratio(PLR), mean platelet volume(MPV), erythrocyte sedimentation rate (ESR), and C-reactive protein(CRP) levels and lower red blood cell (RBC), hemoglobin (Hb), Hematocrit (Hct), LMR, alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL) and albumin/globulin (A/G) levels were noted in axial SpA patients compared to HCs. Positive correlations were observed between LMR and RBC, Hb, Hct and A/G, whereas negative correlations were found between LMR and NLR, PLR, AST, and TBIL (P< 0.05). ROC curves showed that the area under the curve(AUC) for LMR in the diagnosis of ankylosing spondylitis was 0.803 (95% CI =0.734-0.872) with a sensitivity and specificity of 62.8% and 87.2%, respectively, and the AUC (95% CI) for the combination of ESR, CRP and LMR was 0.975 (0.948-1.000) with a sensitivity and specificity of 94.9% and 97.4%, respectively. LMR levels were lower (P<0.05) and significant differences in LMR values were observed among different stages (P<0.05).Conclusions: Our study suggested that LMR might be an important inflammatory marker to identify axial SpA and assess disease activity and X-ray stage of sacroiliitis.

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Disseminated Tuberculosis Mimicking Ankylosing Spondylitis

Case Reports in Rheumatology ◽

10.1155/2011/195085 ◽

2011 ◽

Vol 2011 ◽

pp. 1-4

Author(s):

Valérie Huyge ◽

Serge Goldman ◽

Muhammad S. Soyfoo

Keyword(s):

Ankylosing Spondylitis ◽

Inflammatory Markers ◽

Histological Analysis ◽

Axial Skeleton ◽

Inflammatory Disorder ◽

Disseminated Tuberculosis ◽

Chronic Inflammatory Disorder ◽

Pet Ct ◽

Fdg Pet Ct

Ankylosing spondylitis is a chronic inflammatory disorder affecting mainly the axial skeleton. Here we report a case of a man with a clinical suspicion of ankylosing spondylitis but with a persistence of increased inflammatory markers. In this case,18F-FDG-PET/CT revealed multiple hypermetabolic lesions in axial skeleton, lymph nodes, and the lung, suggestive of either disseminated tuberculosis or lymphoma. Histological analysis of the pulmonary lesion revealed mycobacterium tuberculosis. This case highlights, firstly, the importance of excluding other diagnoses in the presence of clinical picture of ankylosing spondylitis and high inflammatory markers and, secondly, the determining role of PET/CT.

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The role of lymphocyte-monocyte ratio on axial spondyloarthritis diagnosis and sacroiliitis staging

BMC Musculoskeletal Disorders ◽

10.1186/s12891-021-03973-8 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Jing Wang ◽

Jinyu Su ◽

Yuan Yuan ◽

Xiaxia Jin ◽

Bo Shen ◽

...

Keyword(s):

Blood Cell ◽

Disease Activity ◽

Sensitivity And Specificity ◽

Red Blood Cell ◽

Axial Spondyloarthritis ◽

Roc Curves ◽

X Ray ◽

Lymphocyte Ratio ◽

Asas Classification Criteria

Abstract Background Axial spondyloarthritis (axial SpA) is a chronic inflammatory disorder could lead to disability due to the failure of timely treatment. The role of lymphocyte-to-monocyte ratio (LMR) in axial SpA remains unclear. The aim of this study was to investigate the role of LMR in axial SpA diagnosis, disease activity classification and sacroiliitis staging. Methods Seventy-eight axial SpA patients [51males and 27 females; mean age 41.0 (29–52) years] and 78 healthy controls (HCs) [55males and 23 females; mean age 40 (30–53) years] were enrolled in this study. The diagnosis of axial SpA was performed according to the New York criteria or the Assessment of Spondyloarthritis international Society (ASAS) classification criteria, whereas the staging of sacroiliitis in axial SpA patients was determined by X-ray examination. Comparisons of LMR levels between groups were performed using t test. Pearson or Spearman correlation analysis were used to assess correlations between LMR and other indicators. Receiver operating characteristic (ROC) curves were used to determine the role of LMR in the diagnosis of axial SpA. Results Higher neutrophil-to-lymphocyte ratio(NLR), red blood cell distribution width(RDW), platelet-to-lymphocyte ratio(PLR), mean platelet volume(MPV), erythrocyte sedimentation rate (ESR), and C-reactive protein(CRP) levels and lower red blood cell (RBC), hemoglobin (Hb), Hematocrit (Hct), LMR, alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL) and albumin/globulin (A/G) levels were noted in axial SpA patients compared to HCs. Positive correlations were observed between LMR and RBC, Hb, Hct and A/G, whereas negative correlations were found between LMR and NLR, PLR, AST, and TBIL (P < 0.05). ROC curves showed that the area under the curve (AUC) for LMR in the diagnosis of ankylosing spondylitis was 0.803 (95% CI = 0.734–0.872) with a sensitivity and specificity of 62.8 and 87.2%, respectively, and the AUC (95% CI) for the combination of ESR, CRP and LMR was 0.975 (0.948–1.000) with a sensitivity and specificity of 94.9 and 97.4%, respectively. LMR levels were lower (P < 0.05) and significant differences in LMR values were observed among different stages (P < 0.05). Conclusions Our study suggested that LMR might be an important inflammatory marker to identify axial SpA and assess disease activity and X-ray stage of sacroiliitis.

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The role of lymphocyte-monocyte ratio on axial spondyloarthritis diagnosis and sacroiliitis staging

10.21203/rs.2.21180/v5 ◽

2021 ◽

Author(s):

Jing Wang ◽

Jinyu Su ◽

Yuan Yuan ◽

Xiaxia Jin ◽

Bo Shen ◽

...

Keyword(s):

Blood Cell ◽

Disease Activity ◽

Sensitivity And Specificity ◽

Red Blood Cell ◽

Axial Spondyloarthritis ◽

Roc Curves ◽

X Ray ◽

Lymphocyte Ratio ◽

Asas Classification Criteria

Abstract Background: Axial spondyloarthritis (axial SpA) is a chronic inflammatory disorder could lead to disability due to the failure of timely treatment. The role of lymphocyte-to-monocyte ratio (LMR) in axial SpA remains unclear. The aim of this study was to investigate the role of LMR in axial SpA diagnosis, disease activity classification and sacroiliitis staging.Methods: Seventy-eight axial SpA patients [51males and 27 females; mean age 41.0 (29–52) years] and 78 healthy controls (HCs) [55males and 23 females; mean age 40 (30-53) years] were enrolled in this study. The diagnosis of axial SpA was performed according to the New York criteria or the Assessment of Spondyloarthritis international Society (ASAS) classification criteria, whereas the staging of sacroiliitis in axial SpA patients was determined by X-ray examination. Comparisons of LMR levels between groups were performed using t test. Pearson or Spearman correlation analysis were used to assess correlations between LMR and other indicators. Receiver operating characteristic (ROC) curves were used to determine the role of LMR in the diagnosis of axial SpA.Results: Higher neutrophil-to-lymphocyte ratio(NLR), red blood cell distribution width(RDW), platelet-to-lymphocyte ratio(PLR), mean platelet volume(MPV), erythrocyte sedimentation rate (ESR), and C-reactive protein(CRP) levels and lower red blood cell (RBC), hemoglobin (Hb), Hematocrit (Hct), LMR, alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL) and albumin/globulin (A/G) levels were noted in axial SpA patients compared to HCs. Positive correlations were observed between LMR and RBC, Hb, Hct and A/G, whereas negative correlations were found between LMR and NLR, PLR, AST, and TBIL (P< 0.05). ROC curves showed that the area under the curve (AUC) for LMR in the diagnosis of ankylosing spondylitis was 0.803 (95% CI =0.734-0.872) with a sensitivity and specificity of 62.8% and 87.2%, respectively, and the AUC (95% CI) for the combination of ESR, CRP and LMR was 0.975 (0.948-1.000) with a sensitivity and specificity of 94.9% and 97.4%, respectively. LMR levels were lower (P<0.05) and significant differences in LMR values were observed among different stages (P<0.05).Conclusions: Our study suggested that LMR might be an important inflammatory marker to identify axial SpA and assess disease activity and X-ray stage of sacroiliitis.

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Serum-derived extracellular vesicles inhibit osteoclastogenesis in active-phase patients with SAPHO syndrome

Therapeutic Advances in Musculoskeletal Disease ◽

10.1177/1759720x211006966 ◽

2021 ◽

Vol 13 ◽

pp. 1759720X2110069

Author(s):

Yanpan Gao ◽

Yanyu Chen ◽

Lun Wang ◽

Chen Li ◽

Wei Ge

Keyword(s):

Bone Metabolism ◽

Extracellular Vesicles ◽

Inflammatory Marker ◽

Active Phase ◽

Sapho Syndrome ◽

Inflammatory Disorder ◽

Chronic Inflammatory Disorder ◽

Reactive Protein ◽

Amyloid A

Objective: Synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome is a rare chronic inflammatory disorder and the underlying pathogenesis is unclear. In this study, 88 SAPHO patients and 118 healthy controls were recruited to investigate the role of serum-derived extracellular vesicles (SEVs) in SAPHO syndrome. Methods: Quantitative proteomics was applied for SEVs proteome identification, and ELISA and Western blotting was performed to verify the results of mass spectrum data. In vitro osteoclastogenesis and osteogenesis assay was used to confirm the effects of SEVs on bone metabolism. Results: Tandem mass tagging-based quantitative proteomic analysis of SAPHO SEVs revealed differential expressed proteins involved in bone metabolism. Of these, serum amyloid A-1 (SAA1) and C-reactive protein (CRP) were upregulated. Higher SAA1 levels in SAPHO patients were confirmed by ELISA. In addition, SAA1 levels were positively correlated with CRP, an inflammatory marker related to the condition of patients. In vitro celluler studies confirmed that SAPHO SEVs inhibited osteoclastogenesis in patients mainly in the active phase of the disease. Further analysis demonstrated that Nucleolin was upregulated in osteoclasts of active-phase patients under SAPHO SEVs stimulation. Conclusion: In this study, we identified SAA1 as an additional inflammation marker that can potentially assist the diagnosis of SAPHO syndrome, and speculated that Nucleolin is a key regulator of osteoclastogenesis in active-phase patients.

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Fibreoptic intubation in ankylosing spondylitis patients

MedPulse International Journal of Anesthesology ◽

10.26611/10151914 ◽

2021 ◽

Vol 19 (1) ◽

pp. 17-20

Author(s):

Raghu K C ◽

◽

Nagesh R ◽

Viswash G K ◽

◽

...

Keyword(s):

Spinal Cord ◽

Ankylosing Spondylitis ◽

Difficult Airway ◽

Fibreoptic Intubation ◽

Cardiovascular Complications ◽

Inflammatory Disorder ◽

Double Blind Study ◽

Double Blind ◽

Chronic Inflammatory Disorder ◽

Group A

Background: Ankylosing spondylytes is a chronic inflammatory disorder characterized by inflammation in spines and spinal arthritis with a complex polygenic aetiology. The disease is more common in young males and risk factors include both genetic and environmental. Anesthesia management for ankylosing spondylitis is a challenge due to management of difficult airway, respiratory and cardiovascular complications, as well as the medications for disease and pain control. Both airway management and neuraxial access may prove to be difficult. Awake fibreoptic intubation is the safest option (²) in these patients with a potentially difficult airway as it allows continuous neurological monitoring while achieving a difficult airway. Methods: This is a Prospective Randomized Double-Blind Study conducted in Sri Sathya Sai Institute of Higher Medical Sciences; Total 70 Patients (Group A – 35, Group A – 35). All the subjects included after informed consent, blood samples and urine samples are collected from the all the subjects. Hb, RBCs, WBCs and Platelets was measured by laboratory standard methods. Along with Chest X- ray and ECG-for patients over 40 years of age. Results: This study was evaluated that in ankylosing spondylitis cases most of the physicians prefer to give general anaesthesia because to prevent trauma to the spinal cord but in these cases spine and surrounding tissues also it will involve at that time for maintain airway to the patient is challenge to the physicians by using fibreoptic intubation is good way to approach and maintain airway to the ankylosing patients. Conclusion: In this study suggest that in ankylosing spondylitis patients during surgery in place of tracheal intubation fibreoptic intubation is the best way to maintain airway to the patients and also we can prevent spinal cord damage.

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