The efficacy of NIMV has been demonstrated in postoperative ARF, including cardiac, thoracic, thoracoabdominal, and abdominal surgery [1–5]. Various complications may develop following spinal surgery; the most common are cardiac complications (3 %), pulmonary complications (1.2 %), and pneumonia (1.2 %). Postoperative complications were reported to increase mortality; advanced age (>65), comorbidities, and complexity of surgical interventions are contributing factors [6, 7]. It is obvious that scoliosis, trauma, and oncological spinal surgical interventions are more invasive interventions than degenerative disc disease surgery, with higher perioperative morbidity and mortality rates. Moreover, in posterior lumbar fusion operations, mortality is lower than with anterior and thoracic approaches [6]. It has been demonstrated that diabetes mellitus (particularly insulin-dependent), obesity, COPD, and steroid use increase complications in lumbar stenosis surgery [7]. Thoracic disk surgery is particularly associated with pulmonary complications (6.9 %) [8]. In those undergoing anterior/anterolateral decompression and fusion, all complications and pulmonary complications were reported to be greater than in those undergoing posterior/posterolateral decompression and only disc decompression with fusion.

Although we report high mortality and morbidity rates in scoliosis surgery, surgical interventions are needed to improve the quality of life of these patients and for the correction of the vital functions. Irreversibly affected respiratory and cardiac functions may complicate both anesthesia and surgery. Spinal deformity progression may cause deteriorated respiratory functions. Secondary scoliosis may develop in children with muscular dystrophies and myopathies, and, hence, spinal fusion surgery is required. There is alveolar hypoventilation and hypercapnia susceptibility due to respiratory muscle weakness, and inability to cough in scoliosis accompanied by neuromuscular diseases.