Safe intubation in cervical spine injury

Abstract

Traumatic spinal injury is an ongoing community problem. Anatomical stability of the cervical spine depends on the integrity of the bony and ligamentous structures forming the cervical spine. Such stabilising structures are divided into two groups. These are designated anterior and posterior columns. One or both columns may be damaged during traumatic spinal injury. Not all spinal injuries are unstable. Instability may be predicted by viewing anterior-posterior and lateral X-rays of the cervical spine. C1 and C2 injury necessitates special through-mouth views. Instability of the neck requires a different intubation technique. A safe intubation technique is described, the essence of which is to stabilise the neck with longitudinal traction and avoid extension at the fracture site.