Cadaveric study of movement of an unstable atlanto‐axial (C1/C2) cervical segment during laryngoscopy and intubation using the Airtraq®, Macintosh and McCoy laryngoscopes

Summary Concern that laryngoscopy and intubation might create or exacerbate a spinal cord injury has generated extensive research into cervical spinal movement during laryngoscopy. We performed a randomised trial on six cadavers, using three different laryngoscopes, before and after creating a type‐2 odontoid peg fracture. Our primary outcome measure was the change in the space available for the spinal cord at the C1/2 segment measured by cinefluoroscopy. Tracheal intubation was performed using a minimal view of the glottis, a bougie, and manual in‐line stabilisation. In a cadaveric model of type‐2 odontoid fracture, the space available for the cord was preserved in maximum flexion and extension, and changed little on laryngoscopy and intubation.