Laryngoscopy and endotracheal intubation in patients with unstable cervical spines may cause pathological spinal motion and resultant cord injury. Cadaver and mathematical (finite element) models of a type II odontoid fracture predict C1-C2 motions during intubation to be of low magnitude, especially with the use of a low-force videolaryngoscope. Using continuous fluoroscopy, we recorded C1-C2 motion during C-MAC D videolaryngoscopy and intubation in 2 patients with type II odontoid fractures. In these 2 patients, C1-C2 extension and change in C1-C2 canal space were comparable to motions predicted by cadaver and finite element models and did not cause neurological injury.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6697197PMC
http://dx.doi.org/10.1213/XAA.0000000000001000DOI Listing

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