Abstract
INTRODUCTION: Prone positioning in surgery, commonly used in orthopaedics and neurosurgery, carries a high risk of positioning-related injuries. In patients with achondroplasia, anatomical differences present unique challenges for safe surgical positioning. CASE SUMMARY: This case report describes the perioperative management of a 48-year-old woman with achondroplasia undergoing spinal decompression and posterolateral arthrodesis. A detailed preoperative assessment was conducted, including patient participation in testing positions and equipment to ensure both safety and surgical accessibility. A balanced approach was achieved, and intraoperative positioning was continuously monitored. Postoperative evaluation revealed no positioning-related injuries. CONCLUSIONS: This case highlights the critical role of preoperative planning and intraoperative vigilance in preventing complications. It also underscores the need for specific guidelines addressing the positioning of individuals with achondroplasia during surgery, particularly in the prone position, to be incorporated into international standards and best practice recommendations.