Ankylosing spondylitis is an uncommon inflammatory condition that results in stiffness and often deformity of the spine. It starts in young adult life and affects the spine in a progressive way over decades. Pelvic and spinal pains are the early symptoms and these are treated with medications on the advice of a specialist physician. The end result of the disease is spontaneous fusion of the spine, which becomes rigid. Two problems may result from this. Firstly, relatively minor trauma can break the spine and threaten the spinal cord because there is reduced flexibility of the spine; clearly this is an emergency and is managed as such. Secondly, the spine may fuse in a bent over position, leading to difficulties walking and looking forward. If this is the case, consideration may be given to surgical correction of the deformity to permit forward gaze and easier walking. This is major surgery that can completely change people’s lives.