Cervical spine injury and tracheal intubation: are we protecting patients or physicians?

Abstract

Cervical spine injury occurs in 3–4% of patients who suffer trauma, with approximately 25% of these individuals having associated cervical cord injury.¹ Spinal cord injury occurs more frequently in patients who have a lower Glasgow Coma Scale (GCS) and around 25% of patients will have suffered polytrauma with multisystem injuries.¹ As a result, this patient population often requires tracheal intubation for airway protection and to allow management of their injuries, either in the operating theatre or intensive care unit. In addition to this emergent patient cohort, patients at risk of cervical spine injury also present for elective surgery. The potential for cervical cord injury may be due to the surgical procedure itself (for example, cervical disc surgery) or pre-existing cervical canal stenosis, which is a common finding in older patients and may be asymptomatic.²