A New Complication of Spinal Fusion Surgery for Neuromuscular Scoliosis-Posterior Mediastinal Hematoma: Case Report.

Background and importance: Neuromuscular scoliosis surgery is affiliated with a high risk of perioperative and postoperative complications. We present the case of a never-before-reported complication: a posterior mediastinal hematoma.

Clinical presentation: We present the case of a 17-year-old female patient with cerebral palsy and neuromuscular scoliosis with a progressive thoracic kyphosis to 85° and levoscoliosis to 13.5° who presented for spinal fusion surgery. Postoperatively, the patient developed persistent tachycardia despite initial resuscitation, anxiolysis, and analgesia. A computed tomography scan was obtained revealing a posterior mediastinal hematoma. The patient was managed with supportive care and recovered well.

Conclusion: This case highlights a never-before-reported complication of spinal fusion surgery: a posterior mediastinal hematoma. Although unlikely symptomatic, a posterior mediastinal hematoma should be on the differential diagnosis for postoperative tachycardia. This case entreats us to elucidate the true incidence rate of this complication in the population.