"Perioperative Management of Adolescent Idiopathic Scoliosis: Posterior Spinal Fusion of 14 Segments with a Foreseen Blood Loss of 2000 ML (57 % of Total Blood Volume of the Patient) without Transfusion"

Abstract

Adolescent Idiopathic Scoliosis (AIS) is a disease of the spinal column that affects up to 3% of pediatric patients at puberty. In most cases it can be managed conservatively and only a minority develop severe deformities which compromise neurological, pulmonary, cardiac and psychosocial function, requiring surgical management. The main complications of this highly complex operation, which needs careful planing and preparation, is excessive blood loss needing transfusion, and neurological injury. We present the case of a 15 year old male who underwent a bloodless 14 spaces, instrumented posterior spinal fusion without any complications. All the pillars and means of patient blood management (PBM) and meticulous minimally invasive (MISS) surgical technique were applied to achieve a successful result. The dissemination of the management of complex cases like the one we describe, may help other teams worldwide when faced with similar challenges.