posterior fusion in a case of lenke type 2 adolescent idiopathic scoliosis with severe factor vii deficiency: a case report

Background: congenital factor vii (fvii) deficiency is a rare autosomal recessive coagulation disorder that poses significantchallenges during major surgeries, particularly high-risk procedures like instrumented spinal fusion for adolescent idiopathic scoliosis (ais).case report: we present the case of a 15-year-old girl diagnosed with lenke type 2 ais and severe congenital fvii deficiency. she was referred to imam khomeini hospital complex, tehran, iran, for corrective spinal fusion. preoperatively, a single dose of recombinant activated fvii (rfviia) at 20 mcg/kg was administered to maintain hemostasis. the instrumented spinal fusion was performed under general anesthesia using meticulous surgical techniques. notably, no additional doses of rfviia were required during the procedure. conclusion: this case demonstrates that with appropriate preoperative factor replacement and careful intraoperative hemostatic management, patients with severe fvii deficiency can safely undergo corrective spinal fusion. it underscores the critical importance of sustaining hemostasis in managing high-risk surgical patients with coagulopathies.