Common Anesthesia Challenges in a Case of Ankylosing Spondylitis Posted for the Correction of Spinal Deformity

Background: Ankylosing spondylitis (AS) is a type of inflammatory arthritis. Due to the rigid and brittle nature of spinal joints and multisystem involvement in the patients affected by ankylosing spondylitis, they are more prone to developing various complications. Different deformities require several surgical manipulations and perioperative anesthetic challenges, such as difficult intubation and positioning within the operating room. Case presentation: A 42-year-old man was diagnosed with ankylosing spondylitis, which has progressed over the last six years. He suffered from increasing pain and could not look forward, therefore; he has been scheduled for a corrective surgical procedure to address his spinal deformity to alleviate his pain and enhance the quality of his life by improving his functional abilities. Conclusion: Effective management of difficult airway cases with ankylosing spondylitis involving anatomical changes and reduced spinal mobility can be achieved by using awake fiberoptic-assisted nasal intubation. Intraoperative neuromonitoring and careful attention to proper positioning should be considered during the corrective spinal surgery to reduce complications.