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Ankilozan Spondilit, cerrahi hastalarda nadir görülen ve hem genel hem de rejyonal\udanestezi uygulamasının zor olduğu bir kronik, ilerleyici seronegatif spondiloartropatidir.\udSol spermatosel nedeni ile elektif cerrahi planlanan, 38 yaşında\udve 170 cm boyunda, 82 kg ağırlığında, Amerikan Anestezistler Derneği fiziksel\udsınıflaması (ASA) II olan erkek hastada yaklaşık 14 yıldan beri Ankilozan spondilit\udbulunmaktaydı. Servikal eklemlerinde ciddi düzeyde ekstansiyon kısıtlaması\udolduğundan spinal anestezi planlandı. Ancak lomber düzleşme ve sindezmofit\udoluşumu nedeni ile median yaklaşımla iğne girişi mümkün olmayan hastaya\udL4-5 aralığından paramedian yaklaşımla spinal anestezi uygulandı. Sonuç olarak\udileri safhadaki Ankilozan Spondilitli hastalarda paramedian yaklaşımla spinal\udanestezi başarı oranının artabileceği kanısındayız.Ankylosing spondylitis is a chronic, progressive seronegative spondyloarthropathy\udthat is rare among surgical patients and in which application of both general\udand regional anesthesia is difficult. A 38 years-old, and 170 cm height, 82 kg\udweight, ASA class II male patient assigned for an elective left spermatocell surgery,\udhas been followed for Ankylosing Spondylitis since 14 years. Spinal anesthesia\udwas planned beacuse of serious limitation of extension at cervical joints.\udHowever, spinal anesthesia was applied to patient, in whom insertion of needle\udwas impossible because of lumbar flattening and formation of syndesmophytes,\udby paramedain approach at L4-5 spinal space. In conclusion we think that success\udrate may increase by paramedian approach in patients with advanced stage\udAnkylosing Spondylitis

Spinal Anesthesia Application in a Patient with Ankylosing Spondylitis By Paramedian Approach