ABSTRACT : Managing a case of ankylosing spondylitis can be difficult and challenging as airway and vertebral column are deformed yet difficult and associated with extra articular manifestation. Taylor’s approach can be considered ideally in these patients coming for lower limb surgeries. We present a case of 14yr old girl diagnosed as ankylosing spondylitis with extraarticular manifestation coming for lowerlimb surgery anaesthethetic management.

METHODS : Written informed consent was obtained for both regional and general anaesthesia Airway was anticipated to be difficult because of the lack of extension at cervical spine. A difficult airway cart was kept ready along with a flexible fiber-optic bronchoscope. In sitting position using Taylor’s approach subarachanoid blockade achieved with 1.8 ml of 0.5% heavy bupivacaine table tilted laterally

RESULTS : Adequate level of block obtained up to T6 level over Right side and up to T8 level on the left, procedure lasted for 45 minutes.

CONCLUSIONS : Subarachnoid block Taylor’s approach could provide a reliable and less traumatic alternative to the midline approach of lumbar puncture in deformed spine and as an alternative when general anaesthesia and conventional spinal anaesthesia seems to be technically impossible.