We express our condolences to Epaud et al. and to their patient with ankylosing spondylitis who experienced a C5–C6 cervical spine fracture in association with a difficult videolaryngoscopic intubation. Their image report adds to existing reports of intubation-mediated cervical spine injury in patients with ankylosing spondylitis and conveys several important clinical messages.

The first message is neither glottic visualization nor intubation success are guaranteed with videolaryngoscopy. Clinical studies in which cervical spine mobility is artificially restricted—using either manual in-line stabilization or cervical collars—indicate that compared to conventional direct laryngoscopy, videolaryngoscopy: (1) improves glottic view with most but not all videolaryngoscopes and (2) increases first-attempt intubation success with only a few (n = 5) videolaryngoscopes but is not 100%. In two reports of 20 and 30 patients with ankylosing spondylitis in whom the GlideScope (Verathon, USA) was used for intubation, it was not possible to visualize the glottis...

You do not currently have access to this content.