mocdoc

7+ Year Member
15+ Year Member
May 28, 2002
60
0
Visit site
Status
I saw something interesting the other day, a post-op patient was brought to the ICU and I noticed in the PMH that the patient had a history of ankylosing spondylitis with bamboo spine. The patient was intubated in the usual manner using direct laryngoscopy and his hospital corse was uncomplicated.

Is there any contraindication to direct laryngoscopy in this patient and how would you have managed the airway?

Or is this just a boring case with nothing really there? If this is the case anyone care to discuss problems they have seen with direct laryngoscopy?

Ciao
 

DreamMachine

10+ Year Member
Jul 15, 2006
373
3
Status
Attending Physician
.
 

militarymd

SDN Angel
10+ Year Member
15+ Year Member
Dec 17, 2003
5,889
18
Visit site
Status
Attending Physician
if the cervical spine is fused....DL yields nada.
 
About the Ads

Laryngospasm

Trench Dog
10+ Year Member
May 8, 2005
319
10
Missouri
Status
Attending Physician
mocdoc said:
I saw something interesting the other day, a post-op patient was brought to the ICU and I noticed in the PMH that the patient had a history of ankylosing spondylitis with bamboo spine. The patient was intubated in the usual manner using direct laryngoscopy and his hospital corse was uncomplicated.

Is there any contraindication to direct laryngoscopy in this patient and how would you have managed the airway?

Or is this just a boring case with nothing really there? If this is the case anyone care to discuss problems they have seen with direct laryngoscopy?

Ciao
Check airway preoperatively, if neck movement and mouth opening is fine, then should be no different. Believe cervical spine is often spared, if the patient has dentures thats icing on the cake(as always) :)
 

Atropine

Junior Member
10+ Year Member
5+ Year Member
Oct 4, 2004
29
0
Status
As mentioned by others, it involves lumbar spine and not c-spine. The vertebral bodies literally fuse together. Interesting because more likely to be an issue with proper positioning prior to epidurals if the patient can't flex. However, it's unclear (to me) if this affects the ligamentum flavum and other ligaments and thus, the actual placement of the epidural. Anyone actually know the answer to that?
 
About the Ads