Airway Management in Cervical Spine Pathologies

AbstractPurpose of ReviewTraumatic and non-traumatic pathologic processes can make airway management difficult. An understanding of pathologic mechanisms is important in identifying patients at risk. We aim to present a classification of cervical spine pathologies that can affect airway management.Recent FindingsStability of the cervical spine relates to its ability to limit the pattern of displacement under physiologic loads. Traumatic injuries are common but not the only causes of instability. Not all cervical spine pathologies are unstable. Secondary injuries can occur following movement, hypotension, or hypoxemia. Recently, there have been changes in guidelines of cervical spine movement and clearing of the cervical spine. History, physical exam, radiologic study, and communication with the surgeon are keys to planning a successful airway management strategy. Unnecessary immobilization can have deleterious effects. Displacement can happen during mask ventilation and placement of supraglottic airways. Flexible bronchoscopy, videolaryngoscopy, and manual inline stabilization can decrease cervical spine movement. Vigilance during and after extubation is crucial to diagnose airway impairment.SummaryA careful attention to pathophysiology of cervical spine injuries and deformities, review of imaging, and availability of trained and expert individuals are important in the management of these patients.
Source: Current Anesthesiology Reports - Category: Anesthesiology Source Type: research