Abstract
The management of severe kyphoscoliosis in children, particularly those with congenital vertebral anomalies, presents a formidable challenge that requires a highly coordinated, multidisciplinary approach. In this case report, we delve into the complex journey of an 11-year-old female diagnosed with extreme kyphoscoliosis (Cobb's angle 90°) complicated by rib and vertebral dysplasia. This unique presentation not only demanded precision in surgical technique but also necessitated advanced anesthetic strategies and real-time intraoperative monitoring to ensure a successful outcome. Undergoing a major spinal deformity correction and stabilization procedure, the patient benefitted from cutting-edge technologies and tailored anesthetic interventions, designed to mitigate the inherent risks of such intricate surgeries. Remarkably, her perioperative course remained entirely uneventful, and she emerged from surgery with exceptional clinical results. This case underscores the importance of a holistic, collaborative care model-where orthopedic surgeons, anesthesiologists, and specialized support teams work in concert to navigate the complexities of congenital spinal anomalies. Key Clinical Message The management of severe kyphoscoliosis in pediatric patients with congenital vertebral anomalies requires a highly coordinated, multidisciplinary approach to ensure optimal outcomes. This case highlights the value of advanced anaesthetic and surgical techniques, real-time intraoperative monitoring, and personalized anesthetic strategies in achieving successful correction of complex spinal deformities while minimizing perioperative risks.