A patient with ankylosing spondylitis is in an advanced stage. Which precaution is most likely required?

A patient with ankylosing spondylitis is in an advanced stage. Which precaution is most likely required?

• A. Special Precautions for Osteoporosis
• B. Wheelchair for Community Mobility
• C. Assisted Ventilation
• D. Bilateral Ankle-Foot Orthoses

Answer: (A)

Fragile bones from osteoporosis in advanced ankylosing spondylitis make bones prone to fracture with minimal trauma, so protecting the skeleton during all movements and transfers is the most important precaution. The spine in advanced AS is often fused and rigid, and osteoporosis increases vertebral fracture risk even with everyday activities. In practice that means careful handling, avoiding end-range spinal motions, and using safe transfer techniques such as log-rolling with a neutral spine, gentle support, and minimizing twisting or bending of the spine. These precautions help prevent painful, potentially debilitating fractures and complications. Other options might be relevant in different contexts—for example, wheelchair use could be part of managing decreased mobility, and respiratory support could be considered if chest expansion is severely limited—but they do not address the fracture risk driven by osteoporosis in this scenario. Bilateral ankle-foot orthoses would target lower-extremity issues rather than protecting the spine and bones from fragility fractures.

Fragile bones from osteoporosis in advanced ankylosing spondylitis make bones prone to fracture with minimal trauma, so protecting the skeleton during all movements and transfers is the most important precaution. The spine in advanced AS is often fused and rigid, and osteoporosis increases vertebral fracture risk even with everyday activities. In practice that means careful handling, avoiding end-range spinal motions, and using safe transfer techniques such as log-rolling with a neutral spine, gentle support, and minimizing twisting or bending of the spine. These precautions help prevent painful, potentially debilitating fractures and complications.

Other options might be relevant in different contexts—for example, wheelchair use could be part of managing decreased mobility, and respiratory support could be considered if chest expansion is severely limited—but they do not address the fracture risk driven by osteoporosis in this scenario. Bilateral ankle-foot orthoses would target lower-extremity issues rather than protecting the spine and bones from fragility fractures.