Journal article
Cervical spinal motion during intubation : efficacy of stabilization maneuvers in the setting of complete segmental instability
Journal of neurosurgery, Vol.94(2), pp.265-270
2001
DOI: 10.3171/spi.2001.94.2.0265
PMID: 11302629
Abstract
Object: The purpose of this study was to characterize and compare segmental cervical motion during orotracheal intubation in cadavers with and without a complete subaxial injury, as well as to examine the efficacy of commonly used stabilization techniques in limiting that motion.
Methods: Intubation procedures were performed in 10 fresh human cadavers in which cervical spines were intact and following the creation of a complete C4-5 ligamentous injury. Movement of the cervical spine during direct laryngoscopy and intubation was recorded using video fluoroscopy and examined under the following conditions: 1) without stabilization; 2) with manual in-line cervical immobilization; and 3) with Gardner-Wells traction. Subsequently, segmental angular rotation, subluxation, and distraction at the injured C4-5 level were measured from digitized frames of the recorded video fluoroscopy.
Conclusions: After complete C4-5 destabilization, the effects of attempted stabilization on distraction, angulation, and subluxation were analyzed. Immobilization effectively eliminated distraction, and diminished angulation, but increased subluxation. Traction significantly increased distraction, but decreased angular rotation and effectively eliminated subluxation. Orotracheal intubation without stabilization had intermediate results, causing less distraction than traction, less subluxation than immobilization, but increased angulation compared with either intervention. These results are discussed in terms of both statistical and clinical significance and recommendations are made.
Details
- Title: Subtitle
- Cervical spinal motion during intubation : efficacy of stabilization maneuvers in the setting of complete segmental instability
- Creators
- Peter J LENNARSON - Division of Neurosurgery and Departments of Anesthesia and Radiology, The University of Iowa Hospitals and Clinics, Iowa City, Iowa, United StatesDarin W SMITH - Division of Neurosurgery and Departments of Anesthesia and Radiology, The University of Iowa Hospitals and Clinics, Iowa City, Iowa, United StatesPaul D SAWIN - Division of Neurosurgery and Departments of Anesthesia and Radiology, The University of Iowa Hospitals and Clinics, Iowa City, Iowa, United StatesMichael M TODD - Division of Neurosurgery and Departments of Anesthesia and Radiology, The University of Iowa Hospitals and Clinics, Iowa City, Iowa, United StatesYutaka SATO - Division of Neurosurgery and Departments of Anesthesia and Radiology, The University of Iowa Hospitals and Clinics, Iowa City, Iowa, United StatesVincent C TRAYNELIS - Division of Neurosurgery and Departments of Anesthesia and Radiology, The University of Iowa Hospitals and Clinics, Iowa City, Iowa, United States
- Resource Type
- Journal article
- Publication Details
- Journal of neurosurgery, Vol.94(2), pp.265-270
- Publisher
- American Association of Neurological Surgeons; Park Ridge, IL
- DOI
- 10.3171/spi.2001.94.2.0265
- PMID
- 11302629
- ISSN
- 0022-3085
- eISSN
- 1933-0693
- Language
- English
- Date published
- 2001
- Academic Unit
- Radiology; Stead Family Department of Pediatrics; Anesthesia
- Record Identifier
- 9984051549802771
Metrics
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