Airway Management with Rigid Bronchoscope in Adult Patient during Cervical Spine Surgery: A Case Report
SCIWOCTET is a cervical spine injury (CSI) with objective signs of myelopathy, due to trauma, without evidence of ligament injury or bone fractures on x-ray and computed tomography (CT) images. It is rare, found in about 3% of patients with CSI. Perioperative manipulation of these patients may ca...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Sestre Milosrdnice University hospital, Institute of Clinical Medical Research
2023-01-01
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| Series: | Acta Clinica Croatica |
| Subjects: | |
| Online Access: | https://hrcak.srce.hr/file/443955 |
| Summary: | SCIWOCTET is a cervical spine injury (CSI) with objective signs of myelopathy,
due to trauma, without evidence of ligament injury or bone fractures on x-ray and computed tomography
(CT) images. It is rare, found in about 3% of patients with CSI. Perioperative manipulation
of these patients may cause secondary spinal cord injury. The challenge for the anesthesiologist is to
manage an airway with as little movement of the patient’s head and neck as possible. A patient is
presented after a fall from a motorbike. At hospital admission, he had neurological deficit in the innervation
area of the cervical spinal cord. Multi-slice CT of the head and cervical spine was without signs
of acute bone trauma. Magnetic resonance imaging was performed and the diagnosis met the criteria
defining SCIWOCTET. Elective cervical spine surgery under general anesthesia was performed, the
patient was intubated with a rigid bronchoscope using manual in-line immobilization. The selection of
instruments and procedures is emphasized. Other procedures, techniques and instruments that can be
used for airway management and their influence on the movement of the patient’s head and neck are
listed. It is concluded that rigid bronchoscopy with the application of manual in-line immobilization
is suitable for emergency and elective intubation of patients with cervical spine pathology. |
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| ISSN: | 0353-9466 1333-9451 |