Ankylosing spondylitis is a chronic, progressive seronegative spondyloarthropathy that is rare among surgical patients and in which application of both general and regional anesthesia is difficult. A 38 years-old, and 170 cm height, 82 kg weight, ASA class II male patient assigned for an elective left spermatocell surgery, has been followed for Ankylosing Spondylitis since 14 years. Spinal anesthesia was planned beacuse of serious limitation of extension at cervical joints. However, spinal anesthesia was applied to patient, in whom insertion of needle was impossible because of lumbar flattening and formation of syndesmophytes, by paramedain approach at L4-5 spinal space. In conclusion we think that success rate may increase by paramedian approach in patients with advanced stage Ankylosing Spondylitis.
Keywords: Ankylosing spondylitis, spinal anesthesia, paramedian approach