Perioperative challenges in the surgical management of ankylosing spondylitis

Patients with ankylosing spondylitis (AS) who present with spinal lesions are at an increased risk for developing peri-operative complications. Due to the rigid yet brittle nature of the ankylosed spines commonly occurring with severe spinal deformity, patients are more prone to developing neurological deficits. Such risks are potentially increased not only during surgical manipulation or deformity correction, but also during image acquisition, positioning within the operating room, and intubation. In this review the complications of AS are reviewed, and recommendations are provided to avoid problems during each stage of patient management.