Delayed Postoperative Spinal Cord Injury with Complete Paralysis After Adolescent Idiopathic Surgery: A Case Report.

Case: We report a 14-year-old girl with adolescent idiopathic scoliosis who experienced bilateral lower extremity paralysis related to postoperative hypotension 10 hours after posterior spinal fusion. She returned to the operating room for spinal cord decompression and hardware removal. Six weeks later, reinstrumentation was performed, and complete neurologic recovery was achieved.

Conclusion: Delayed presentation of neurologic injury after scoliosis surgery is particularly uncommon. Close postoperative monitoring, with an emphasis on hypotensive etiologies and a low threshold to remove the instrumentation, is essential to rapidly diagnose and treat these catastrophic events.