Cervical Spinal Motion During Orotracheal Intubation.
Abstract
Sixteen fresh human cadavers were intubated while recording cervical motion using a cine fluoroscopic technique. Segmental cervical motion from the occiput through C5 was measured in both the intact spine and following the creation of a C4-5 posterior ligamentous injury in all cadavers. Each intubation was performed using no external stabilization, Gardner-Wells traction and manual in-line cervical immobilization. The cadaveric spine motion accurately reflected previously reported segmental motion in living patients. Traction decreased craniovertebral junction motion, but neither traction nor immobilization reduced motion at the destabilize C4-5 level. Four patients without significant cervical pathology and normal motion of flexion/extension views underwent fluoroscopic monitoring during intubation without and with traction. The traction was applied by hand using Gardner-Wells tongs. One patient could not be intubated safely while traction was administered. Although we have not yet studied enough subjects to do a statistical analysis, the data compare very favorably with that from the cadaver study. Traction during intubation decreases motion of all cervical segments in live patients, with the C2-C3 and C4-C5 levels most affected.
Document Details
- Document Type
- Technical Report
- Publication Date
- Jan 01, 1998
- Accession Number
- ADA337480
Entities
People
- Vincent C. Traynelis
Organizations
- University of Iowa