Posterior spinal fusion for adolescent idiopathic scoliosis in a Jehovah’s Witness

We report the case of an adolescent Jehovah’s Witness with Lenke type 6C+ adolescent idiopathic scoliosis who underwent posterior spinal fusion at a tertiary spine centre. The patient declined allogeneic blood transfusion but consented to intraoperative autologous cell salvage and the use of topical haemostatic agents. A structured multimodal blood-conservation protocol comprising tranexamic acid, controlled hypotensive anaesthesia, meticulous haemostasis and intra-operative cell salvage enabled safe completion of a 5–6-hour procedure without transfusion. This case adds to the limited literature describing scoliosis correction in Jehovah’s Witness patients and highlights the ethical, surgical and perioperative considerations necessary to achieve a successful outcome in this complex setting.