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Management of Patient with Cervical Spine Injury

  • Daniel Van Leuven
  • Ehab FaragEmail author
Chapter
  • 28 Downloads

Abstract

A 49-year old male with no significant medical history presented with a myelopathy secondary to a large extended C5–C6 disc herniation with compression of the spinal cord. The patient was classified as grade 2 on the Narick’s functional scale. The patient was scheduled for a single-level discectomy, decompression, reconstruction, and stabilization. Due to motor weakness, pain in the upper and lower limbs with neck movement, and examination of the patient’s MRI, the decision was made to safely secure the patient’s airway with an awake fiber-optic intubation (FOI). After being premedicated with 2 mg of midazolam and 0.2 mg of glycopyrrolate, the upper airway was anesthetized using nebulized 4% lidocaine, and the patient was intubated smoothly.

References

Question 1

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Question 2

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    Farag E. Airway management for the cervical spine surgery. Best Pract Res Clin Anaesthesiol. 2016;30:13–25.CrossRefGoogle Scholar

Question 3

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    Sahin A, Salman MA, Erden IA, Aypar U. Upper cervical vertebrae movement during intubating laryngeal mask, fibreoptic and direct laryngoscopy: a video-fluoroscopic study. Eur J Anaesthesiol. 2004;21(10):819–23.CrossRefGoogle Scholar

Question 4

  1. 4.
    Farag E. Airway management for the cervical spine surgery. Best Pract Res Clin Anaesthesiol. 2016;30:13–25.CrossRefGoogle Scholar
  2. 5.
    Sahin A, Salman MA, Erden IA, Aypar U. Upper cervical vertebrae movement during intubating laryngeal mask, fibreoptic and direct laryngoscopy: a video-fluoroscopic study. Eur J Anaesthesiol. 2004;21(10):819–23.CrossRefGoogle Scholar

Question 5

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    Farag E. Airway management for the cervical spine surgery. Best Pract Res Clin Anaesthesiol. 2016;30:13–25.CrossRefGoogle Scholar

Question 6

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    Santoni BG, Hindman BJ, Puttlitz CM, Weeks JB, Johnson N, Maktabi MA, Todd MM. Manual in-line stabilization increases pressures applied by the laryngoscope blade during direct laryngoscopy and orotracheal intubation. Anesthesiology. 2009;110:24–31.CrossRefGoogle Scholar

Question 7

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Question 8

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Question 11

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Question 14

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Question 15

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    Tasiou A, et al. Anterior cervical spine surgery-associated complications in a retrospective case-control study. J Spine Surg. 2017;3:444–59.CrossRefGoogle Scholar

Suggested Reading

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  9. Tasiou A, et al. Anterior cervical spine surgery-associated complications in a retrospective case-control study. J Spine Surg. 2017;3:444–59.CrossRefGoogle Scholar
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Copyright information

© Springer Nature Singapore Pte Ltd. 2020

Authors and Affiliations

  1. 1.Cleveland Clinic Lerner College of MedicineClevelandUSA
  2. 2.Department of General AnesthesiaAnesthesiology Institute, Cleveland ClinicClevelandUSA
  3. 3.Department of Outcomes ResearchAnesthesiology Institute, Cleveland ClinicClevelandUSA

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