Manual In-Line Stabilization Is Not Helpful in Cadavers with Unstable C-Spines

Movement of the unstable C-spine during intubation was similar with and without use of this currently recommended technique.

Given that direct laryngoscopy (DL) can cause motion of the cervical spine in normal or uninjured patients, the technique has been suggested, but not proven, to cause or exacerbate C-spine injury in patients with unstable C-spines. Manual in-line stabilization (MILS) of the C-spine is recommended to mitigate this possibility. In this study, unstable C-spine injuries were created at C4–C5 in 10 adult cadavers via surgical disruption of the anterior and posterior longitudinal ligaments, the disc, and the annulus. A single experienced anesthesiologist intubated the cadavers in random order with a 7.0-mm wire-reinforced endotracheal tube by either DL (Macintosh blade) or a Bullard rigid fiber-optic laryngoscope (BL), with and without MILS. Digi…

Reviewing Author

John A. Marx, MD, FAAEM