title: Percutaneous dilational tracheostomy after anterior cervical spine fixation.
abstract: After spinal cord injury, quadriplegic patients generally require tracheostomy for ventilatory support and airway clearance. Early tracheostomy has several advantages over translaryngeal intubation, but in patients who undergo anterior surgical fixation of the spine, it is often delayed until after recovery of the surgical wound. We report the case of a quadriplegic patient who underwent a successful percutaneous dilational tracheostomy with the Ciaglia technique after surgical fixation of the spine. The percutaneous dilational technique minimizes the injury to the adjacent structures of the neck and the risk of stomal infection. Therefore, it should be considered the technique of choice when an early tracheostomy is indicated for quadriplegic patients who have undergone anterior surgical fixation of the cervical spine.
authors.affiliation: 2nd Department of Anesthesia and Intensive Care, S.M. dei Battuti City Hospital, Treviso, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Mazzon
authors.forename: E
authors.initials: E
authors.lastname: Di Stefano
authors.forename: G
authors.initials: G
authors.lastname: Dametto
authors.forename: M
authors.initials: M
authors.lastname: Nizzetto
authors.forename: G
authors.initials: G
authors.lastname: Cippolotti
authors.forename: E
authors.initials: E
authors.lastname: Bosco
authors.forename: C
authors.initials: C
authors.lastname: Conti
authors.forename: G
authors.initials: G
authors.lastname: Giuliani
mesh_terms: D000328:Adult; D001424:Bacterial Infections / Q000517:prevention & control; D002574:Cervical Vertebrae / Q000293:injuries* / Q000601:surgery*; D004106:Dilatation; D005592:Fracture Fixation; D006801:Humans; D008297:Male; D009333:Neck / Q000601:surgery; D019838:Neck Injuries; D011782:Quadriplegia / Q000601:surgery; D012121:Respiration, Artificial; D012128:Respiratory Distress Syndrome / Q000628:therapy; D012307:Risk Factors; D016103:Spinal Fractures / Q000601:surgery*; D013396:Suction; D014139:Tracheostomy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D015300:Ventilator Weaning