[Anesthetic management for posterior spinal fusion in a patient with ankylosing spondylitis and osteoporosis].

An 83-year-old woman was admitted to our hospital with fracture of the T11 vertebral body and paraplegia. Complications included ankylosing spondylitis and osteoporosis. The vertebra was acutely deviated and thus at risk of being crushed had manual correction of the dislocation been attempted. Instead, we predicted that placing the patient in an appropriate posture during surgery would allow the dislocation to correct spontaneously. Three possible postures were proposed by the orthopedic surgeon at a conference that was also attended by operative nurses. A Hastings posture was finally used intraoperatively. No complications arising from the posture itself were noticed during or after surgery. We concluded that a preoperative conference among doctors and nurses can eliminate unnecessary confusion in cases when special postures are utilized during surgery.