Failed reintubation during resuscitation after posterior occipito-cervical spinal fusion: A case report

RATIONALE: Posterior occipito-cervical spinal fusion (OCF) is a common surgical method for atlantoaxial dislocation, but postoperative airway complications may occur. Reintubation has been reported in the past, but the failure of reintubation is rare. PATIENT CONCERNS: A 54-year-old woman who underwent OCF due to rheumatoid cervical spondylosis and atlantoaxial dislocation. In the postanesthesia care unit, the patient developed upper respiratory tract obstruction after extubation. DIAGNOSES AND INTERVENTIONS: It is an upper respiratory tract obstruction due to anatomical changes because of surgery. Emergency airway management was activated, but it did not work. OUTCOMES: Emergency reintubation failed, and the patient was finally saved after tracheotomy. LESSONS: For patients who underwent OCF due to cervical spondylosis caused by rheumatoid arthritis, great attention should be paid to the perioperative airway management, especially during the recovery period. And more important, adequate reintubation preparatory work should be done before extubation.