Transfusion Requirements During Spinal Surgery for Severe Scoliosis
Transfusion Requirements During Spinal Surgery for Severe Scoliosis
Corrective surgery for scoliosis can result in prolonged operating room time and significant
 blood loss. The investigators goal is to determine what the transfusion requirements are for
 young adults undergoing spinal surgery for scoliosis and what other intra-operative factors
 influence the amount of blood and blood products used. The investigators will used the
 information obtained to improve the management of patients undergoing corrective surgery for
 scoliosis.
Data collected prior to surgery will include patients' past medical history, hemoglobin
 concentration, INR, MCV, gender, age and weight.

 Immediately prior to surgery, but after induction of anesthesia, subjects will have another
 complete blood count drawn to assess preoperative hemoglobin/hematocrit concentrations. This
 is customarily done to establish a baseline. During surgery patient's core temperature,
 hemoglobin, hematocrit levels, estimated blood loss, Central Venous Pressure, blood pressure,
 heart rate, cell saver, the amount of irrigation fluid, colloid, crystalloid, blood and blood
 products will be recorded hourly throughout surgery. All of the data collection described is
 standard in these types of cases.

 Patients will be transfused allogenic blood if hemoglobin levels fall below 8.0 g/dL or
 patients present with clinical signs/symptoms of hypovolemia (hypotension, tachycardia). Data
 collection concerning allogenic blood transfusion will include intraoperative transfusion
 rate, volume of transfused units per patient and transfusion index. Surgical intervention
 data regarding the extent of the surgical procedure will be collected: the number of curves,
 the curve magnitude, type of instrumentation required, the number of levels fused and the
 fluoroscopy time. The placement and type of wound drains and their .respective outputs will
 be noted. Preoperative and postoperative curve magnitude will be documented as well as
 instrumentation used to facilitate curve correction. The number of levels fused will be
 documented.

 Hemoglobin and hematocrit levels will be noted at several intervals post operatively (24
 hours, 48 hours and last result prior to discharge) and further transfusion requirement will
 be recorded. The length of Intensive Care Unit stay and the length of hospital stay will be
 noted. Regarding surgical procedure all patients will be operated on by the same surgical
 team, under standardized anesthesia, total intravenous anesthesia (TIVA), and postoperative
 analgesia. Data will be expressed as percentages or as a mean +/- SD. T-test analysis will be
 used for comparison for quantitative variables and a p value < 0.05 will be considered
 statistically significant
Inclusion Criteria:

 -  all patients undergoing surgical correction of scoliosis