CASE REPORT
Year : 2016  |  Volume : 10  |  Issue : 1  |  Page : 101-103

Fluoroscopy guided transforaminal epidural anesthesia in ankylosing spondylitis


1 Department of Anaesthesiology, Subbaiah Institute of Medical Sciences, Shivamogga, Karnataka, India
2 Department of Oral Pathology, Subbaiah Institute of Dental Sciences, Shivamogga, Karnataka, India
3 Department of Surgery, Subbaiah Institute of Medical Sciences, Shivamogga, Karnataka, India

Correspondence Address:
S M Channabasappa
SSS Mansion, 3rd Cross, Basaveshwara Nagar, Shivamogga - 577 201, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1658-354X.169486

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A 48-year-old male patient with a long-standing history of ankylosing spondylitis (AS) presented for ureteroscopic stone removal. On preoperative assessment, tracheal intubation was likely to be difficult due to decreased cervical spine mobility. Traditional neuraxial block was impossible due to the fusion of vertebral bodies. AS patients present the most serious array of intubation, which is secondary to decrease in cervical spine mobility and possible temporomandibular joint disease. Management of a case of AS can be very challenging when the airway and the central neuraxial blockade, both are difficult. Fluoroscopic assisted central neuraxial blockade may lead to predictable success in AS. We present a case report with severe AS where conventional techniques failed and C-arm assisted helped in successful epidural anesthesia for ureteroscopic stone removal.


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