Ankylosing spondylitis: Epidural risks


Neuraxial anesthesia is complicated by ossification of spinal ligaments and reduced intervertebral spaces – caudal anesthesia may be a reasonable alternative.

  • Systemic Considerations: uveitis, vasculitis, aortic insufficiency, pulmonary fibrosis, restrictive lung disease
  • General Anesthesia: reduced cervical and TMJ mobility
  • Regional Anesthesia: osseous ligaments, reduced intravertebral spaces (consider caudal)


    Miller, RD et al. Miller’s Anesthesia, 7th ed, Churchill Livingstone: p. 1035, 2246, 2009

    Can J Anaesth. 1997 Dec;44(12):1319

    [PubMed: 8955979]

    Anaesthesia;2005 Jun;60(6):624-5

    [PubMed: 15918842]

    Eur J Anaesthesiol;2006 Oct;23(10):897-8

    [PubMed: 16953949]

    Acta Anaesthesiol Scand. 2005 May;49(5):722

    [PubMed: 15352971]


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