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841 - Interdisciplinary Care of a Patient with Hemophilia C undergoing Cervical Disc Fusion

Friday, February 28, 2025

5:00 PM - 6:30 PM MST

Presenting Author(s)

AC

Anela Carrazana Yero, BS

Medical Student
University of Central Florida College of Medicine
Miami, Florida, United States

Co-Author(s)

AC

Ashin Chadha, BS

Medical Student
NSU KPCOM
Jacksonville, Florida, United States

Co-Author(s)

JE

John Evans, II, DO

D.O.
Mayo Clinic Florida
jacksonville, Florida, United States

Case Diagnosis: Hemophilia C, caused by a deficiency in Factor XI, is a rare bleeding disorder characterized by mild to moderate bleeding tendencies. Given that this disorder has an increased risk of bleeding, managing surgical patients with Hemophilia C requires careful planning and coordination to prevent perioperative complications.

Case Description: Here we are presenting a 79-year-old male with a Past Medical History of Hemophilia C, who has been complaining of neck pain with radiation down the R arm These symptoms of neck pain and numbness down the arm, have been unresponsive to conservative treatments. MRI of the cervical spine revealed posterior decompression changes, necessitating disc fusion surgery. Prior to surgery, Hematology was consulted, and a comprehensive evaluation of the patient's coagulation profile, including factor XI levels, and bleeding history was done. A personalized coagulation management plan was developed, including the utilization of pre-operative therapeutic plasma exchange therapy. Unfortunately, the patient's postoperative course was complicated by an acute hypoxic respiratory event for which he was treated in the hospital for 20 days.

Discussions: This case underscores the importance of an interdisciplinary approach in managing patients with rare bleeding disorders undergoing major surgery. Administration of repeated doses of coagulation factor preparations over a prolonged period can lead to the development of inhibitors, thus necessitating a meticulous review of coagulation factors. Coordination among healthcare professionals is crucial to ensure optimal outcomes. For patients with Hemophilia C, preoperative planning, intraoperative vigilance, and postoperative care are essential to prevent and manage bleeding complications. This report highlights the coordinated efforts of hematologists, anesthesiologists, surgeons, physiatrists, and other healthcare professionals to ensure optimal outcomes for the patient.

Conclusions:
The successful management of this patient with Hemophilia C undergoing disc fusion surgery highlights the critical role of an interdisciplinary team. Personalized coagulation management and meticulous surgical and anesthetic techniques were key to preventing complications.