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Unstable cervical spine; is it still a contraindication for percutaneous tracheostomy as thought before?

Authors:

Amila Jayasinghe ,

Teaching Hospital, Kandy, LK
About Amila
Senior Registrar in Anaesthesia, Neurosurgical Intensive Care Unit
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Ravi Weerakoon,

Teaching Hospital, Kandy, LK
About Ravi
Consultant Anaesthetist, Neurosurgical Intensive Care Unit
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Udaya Karunarathne

Teaching Hospital, Kandy, LK
About Udaya
Consultant Anaesthetist, Neurosurgical Intensive Care Unit
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Abstract

We report a 28 year old male with an unstable acute traumatic cervical spinal cord injury (SCI) due to anterior spondylolisthesis of C6 over C7 vertebra and facet joint dislocation of C6-C7 who underwent a successful bronchoscopy guided percutaneous tracheostomy (PCT) on day 6. Cervical SCI demands tracheostomy in majority but SCI with unstable cervical spine itself makes tracheostomy a challenging procedure. Even though cervical SCI was considered a relative contraindication for PCT, it can be safely performed in neutral neck position. Addition of ultrasound scanning of neck and bronchoscopic guidance further increases its safety profile. In cervical SCI early tracheostomy may be more effective than late.
How to Cite: Jayasinghe, A., Weerakoon, R. and Karunarathne, U., 2020. Unstable cervical spine; is it still a contraindication for percutaneous tracheostomy as thought before?. Sri Lankan Journal of Anaesthesiology, 28(2), pp.165–167. DOI: http://doi.org/10.4038/slja.v28i2.8615
Published on 30 Jun 2020.
Peer Reviewed

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