Perioperative management of Adolescent Idiopathic Scoliosis: Posterior Spinal Fusion of 14 Segments with A Foreseen Blood Loss of 2000ml (57% of Total Blood Volume of the Patient) Without Transfusion

Abstract

foreseen 57% total blood volume (TBV) (2000ml) loss, without recurring to allogenic blood product transfusion. Specific anesthetic and minimally invasive surgical techniques (MISS) were used [1-5]. We present 15 years old (50kg, 160cm, body mass index 19,5 kg/m2, total body surface 1.49m2), Latino male with AIS of the thoracolumbar spine (T2-L4) with curves of 78º and 42º 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 planning 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.