<![CDATA[Introduction: Scoliosis correction surgery requires careful anesthetic management because of potential perioperative complications, including excessive bleeding, hypothermia, complications related to patient positioning, and the need for spinal cord protection. Case: A 23-year-old woman weighing 32 kg with a height of 140 cm presented with a chief complaint of spinal deformity that had been present since childhood. On physical examination, her blood pressure was 119/79 mmHg, pulse rate was 112 beats/minute, respiratory rate was 20 breaths/minute, and SpO2 was 97% on room air and a Cobb angle of 90°. Anesthesia induction using propofol 70 mg, while tracheal intubation was facilitated with atracurium 0.5 mg/kg. Analgesia with fentanyl 2 µg/kg, and anesthesia with O2/air, sevoflurane, and atracurium infusion at 0.5 mg/kg/hour. Intravenous tranexamic acid 500 mg to minimize intraoperative bleeding. Intraoperative monitoring consisted of standard monitoring modalities, without the use of spinal cord monitoring. The surgical procedure lasted 4 hours and 20 minutes, with the patient positioned prone throughout the operation. Discussion: The most important principle of anesthetic management in spinal surgery is a comprehensive and meticulous approach to patient positioning, ensuring safe alignment while maintaining adequate spinal cord perfusion pressure. Spinal cord protection was provided with methylprednisolone, hemodynamic stable, normothermia, good patient position.Conclusion: Spinal cord protection did with avoid excessive bleeding, hypothermia, complications related to patient positioning, and maintaining adequate spinal cord perfusion pressure. ]]>
