Louisiana Via Research Day Book 2026

Case Studies: Section 1

Nick Cabral, BS 1; Lynnell Danie,l MD 2 ; Jenna Dittmar, PhD 1 1 VCOM-Louisiana; 2 Willis Knighton Department of Pediatric Anesthesiology 85 ANESTHETIC MANAGEMENT OF A COMPLEX SPINAL FUSION IN A PATIENT WITH SEVERE DEXTROSCOLIOSIS: A CASE REPORT

Background: This case report describes the anesthetic and surgical challenges in the management of a severe case of adolescent idiopathic scoliosis. A 15-year-old female presented with progressive thoracic back pain and was found to have a 130 degrees dextroscoliosis spanning T2–L3. Her treatment plan involved posterior spinal fusion with pedicle screw instrumentation under total intravenous anesthesia (TIVA). Airway management required placement of a wire reinforced endotracheal tube to minimize kinking during prone positioning. Anesthetic goals included maintaining stable hemodynamics and optimizing mean arterial pressure to preserve spinal cord perfusion while allowing reliable neurophysiologic monitoring. During pedicle screw placement at T7, motor evoked potentials (MEPs) revealed loss of left lower extremity signals. Despite removal of the implicated pedicle screws, MEP signals did not return. A wake-up test was performed after completion of proximal screw placement, which confirmed absent voluntary motor response in the lower extremities. The procedure proceeded with rod placement and closure. Two days later, the patient underwent re-exploration with removal

of right-sided pedicle screws from T2-T3, resulting in partial intraoperative motor recovery. Postoperatively, the patient demonstrated gradual bilateral motor improvement, with the eventual reinsertion of pedicle screws at T2-T3 and T6. The anesthetic management of major spinal deformity correction presents unique challenges requiring close coordination with surgical and neuromonitoring teams. This case highlights the importance of meticulous anesthetic planning, vigilant intraoperative monitoring, and readiness to respond to neurologic changes to ensure patient safety during complex spinal procedures.

Case Studies: Section 2

IN THE PHOTO: Kayla Griffith, Class of 2028

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2026 Research Recognition Day