Spine surgery for scoliosis correction in pediatric patients is a major procedure associated with a high risk of perioperative blood loss. Homologous blood transfusion carries inherent risks, including immunological reactions, infections, and increased healthcare costs. Identifying high-risk patients is crucial to optimize blood conservation strategies. This retrospective study aims to identify preoperative and intraoperative risk factors associated with homologous red blood cell (RBC) transfusion and to evaluate the quantitative impact of Cell Saver volume reinfusion on reducing homologous transfusion requirements.

Inclusion Criteria:

• Patient aged under 18 years (< 18 years old).
• Programmed surgical correction for scoliosis (including idiopathic, neuromuscular, and congenital etiologies).
• Instrumented surgery involving posterior spinal arthrodesis.

Exclusion Criteria:

• Revision spine surgeries.
• Known constitutional hemostasis disorders.
• Non-orthopedic spine surgeries.
• Missing core clinical or transfusion data.

The study population consists of pediatric patients under 18 years of age who underwent major orthopedic spine surgery for scoliosis correction at a single specialized tertiary center. The cohort includes individuals with various scoliosis etiologies-such as idiopathic, neuromuscular, and congenital scoliosis-who required instrumented posterior spinal arthrodesis. Patients are selected from the institutional surgical registry over a continuous 3-year period (from April 2023 to March 2026)