Firstly, ankylosing spondylitis is an autoimmune disease primarily affecting the axial joints, but it can also present with extra-articular manifestations. Severe cases can lead to ankylosis and deformities of the spine, which are complications of late-stage ankylosing spondylitis. At this stage, surgery is needed to manage the activity of the disease. If the activity of the disease is not controlled, even joint replacement can still lead to the progression of the disease and further damage to the joint structures. For severe disabling deformities, spinal orthopedic surgery can be considered, and spinal surgery is required when an acute fracture occurs.