Esketamine combined with sevoflurane anaesthesia for transurethral resection of the prostate in ankylosing spondylitis with severe thoracolumbar kyphoscoliosis: a case report and literature review

Single-stage bilateral conversion arthroplasty for hip fusion via direct anterior approach in a patient with severe ankylosing spondylitis and kyphoscoliosis: a case report

“…These factors not only hinder patient mobility but also restrict respiratory capacity [ 16 , 17 ]. This issue is much more prominent in cases with AS and accompanying spine deformities like kyphoscoliosis that multiplies the challenges due to cervical spine and temporomandibular joint mobility limitations and further restrictions in respiratory capacity as in these complex cases the thoracolumbar spine is severely affected and deformed [ 12 , 18 ].…”

“…In a study by Kuwaijo and colleagues on a 58-year-old man with AS and severe kyphoscoliosis who was diagnosed with prostate carcinoma, the surgeons placed the patient under general anesthesia in the supine-Trendelenburg-Lithotomy position and performed the robot-assisted radical prostatectomy and this way they could overcome the complex state of the patient and the surgery was successful [ 19 ]. The second case was a 73-year-old man with AS and severe thoracolumbar kyphoscoliosis diagnosed with benign prostatic hyperplasia and was a candidate for transurethral resection of prostate under regional anesthesia; however, due to failure of epidural anesthesia because of spine deformity, and the team decided to use low-dose esketamine combined with sevoflurane inhalation to anesthetize patient to perform the intervention and they were successful [ 12 ]. Review of these two cases show the difficulty of any surgery even non-orthopedic and not on the fused hips in these complicated cases.…”

“…However, simultaneous presence of AS and spine deformities like kyphoscoliosis is a relatively rare phenomenon reported in studies, with almost none of them targeted to repair the hip fusion [ 12 – 15 ]. In the rare case we present in this study, the patient was diagnosed with AS and severe kyphoscoliosis who was suffering from bilateral hip ankylosis that underwent single-stage bilateral hip fusion conversion to THA after spine surgery that corrected the kyphoscoliosis and let us to place the patient in supine position and perform conversion surgery in one session.…”