Spondilita anchilozantă (SA) este o boală reumatismală inflamatorie cronică, care afectează în principal scheletul axial și cutia toracică. Studii de specialitate au subliniat pentru stadiile avansate afectarea neurologică marcată, reprezentată prin: stenoza de canal medular (afectarea segmentului cervical sau lombar cu mielopatie sau radiculopatie secundară), sindrom de coadă de cal și subluxaţie atlaso-occipitală. Obiective: În studiul de faţă ne-am propus să evaluăm manifestările neurologice ale pacientului diagnosticat cu SA, ca rezultat a remanierii structurilor segmentului lombar.

Ankylosing spondylitis (AS) is a chronic infl ammatory rheumatic disease that aff ects primarily the axial skeleton and the thoracic cage. As the modern reports suggests, the advanced stages of disease may present neurological complications such as: spinal stenosis (impact on cervical or lumbar spine canal with: myelopathy, radiculopathy secondary to vertebral fractures ossifi cations and compression of the nerve roots), cauda equina syndrome and vertebral C1-C2 subluxation. AIM. the main outcome of the current study was to evaluate the neurological involvement of AS. We focused on the neurological manifestations secondary to lumbar spine damage. Material and methonds. this is a prospective study on 27 consecutive patients with AS (New York criteria 1984) with advanced stages of the disease defined by sacroiliitis grade III and IV. Assessments were done according to a predefi ned protocol and included: (i) rheumatology domain (individual clinical and laboratory parameters, disease scores – Bath ankylosing sponylitis metrology index - BASMI and Bath ankylosing sponylitis functional index – BASFI), (ii) radiological evaluation – standard lumbar spine and sacroiliac joint radiography and lumbar spine IRM, (iii) neurological clinical evaluation, (iiii) neurological laboratory testing that included: Electromyography (EMG) of the crural muscle, Nerve Conduction Tests (NCT) for crural and sciatic nerves, Somatosensory (SSEP) and magnetic motor (MEP) evoked potentials for lower limb. SPSS-17 was used for statistical analysis. Results. Patients presented active forms of disease with important functional impairment (BASMI – mean: 6,7, BASFI – mean: 5,8) and an average duration of illness of 8.7 years. Radiological features: sacroiliitis grade III –77,7% (n= 21), grade IV – 6 cases. Eight patients had clinical neurological manifestations, out of which one case of myelopathy and 7 cases with radiculopathy. We found neurophysiological test abnormalities (one or more tests) at 17 patients: the EMG valuation found 4 cases with neuropathic features of crural muscle, Nerve Conduction Tests (NCT) were abnormal for crural in 4 cases and sciatic nerves in 9 cases. Fifteen (55,5%) patients had SSEP abnormalities and 62,9% (n=17) modified result for MEP . Conclusion. Patients with severe forms of AS may present neurological complications. Th e high frequency of subclinical complications suggests that neurophiosiological test are useful to assess the early neurological manifestations.