Anesthetic Challenges in a Patient with Ankylosing Spondylitis Undergoing Corrective Spinal Surgery: A Case Report

Arash  Heroabadi; Reza Atef  Yekta; Iman Asdaghi  Jahrom; Keihan  Shabankhani

doi:10.18502/crcp.v9i5.18458

Arash Heroabadi Brain and Spinal Cord Injury Research Center, Neuroscience Institut, Tehran University of Medical Science, Tehran, Iran
Reza Atef Yekta Pain Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
Iman Asdaghi Jahrom Department of Anesthesiology and Critical Care, Dr. Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
Keihan Shabankhani Department of Anesthesiology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran

DOI: https://doi.org/10.18502/crcp.v9i5.18458

Keywords: Anesthetic challenge; Ankylosing spondylitis; Neuromonitoring

Abstract

Ankylosing spondylitis (AS) is a progressive inflammatory disease characterized by spinal rigidity, kyphotic deformities, and significant challenges in airway management during surgery. We report the case of a 50-year-old male with severe kyphosis caused by long-standing AS, scheduled for corrective spinal surgery. Preoperative assessment revealed restricted cervical mobility, a “chin-on-chest” deformity, and a high risk of difficult intubation. Awake video-laryngoscopy-assisted intubation, combined with regional airway blocks, was successfully performed to minimize complications. Intraoperative neuromonitoring, strategic positioning, and meticulous hemodynamic management were implemented to ensure patient safety. The surgery was completed without neurological deficits, and the patient was discharged in stable condition. This case underscores the importance of thorough airway planning, neuromonitoring, and intraoperative vigilance in AS patients undergoing spinal correction. It highlights the critical role of a multidisciplinary approach in achieving successful surgical outcomes.