Related Experiment Video
Updated: Apr 16, 2026
Minimally Invasive Murine Laryngoscopy for Close-Up Imaging of Laryngeal Motion During Breathing and Swallowing
Published on: December 1, 2023
Randomized cinefluoroscopic comparison of cervical spine motion using McGrath series 5 and Macintosh laryngoscope for
Background:
Intubation in patients with suspected cervical spine injury must be cautiously performed to avoid any further neurologic trauma. Several intubation techniques have been introduced to minimize cervical spine motion such as the use of the videolaryngoscope.
Objective:
The present study aims to compare the movement of the cervical spine during intubation by using McGrath series 5 videolaryngoscope (MGL) and that of the conventional Macintosh laryngoscope from cinefluoroscopic imaging.
Material And Method:
Twenty-two patients undergoing elective orthopedic surgery that did not involve cervical spine procedure and required general anesthesia were recruited into the study. All patients were randomized either to have intubation with MGL (n = 11) or Macintosh laryngoscope (n = 11) in a neutral position with manual in-line stabilization (MILS). The primary outcome was the cervical vertebral angle changes pre- and post-intubation, measured by cinefluoroscopy. The number of intubation attempts, the laryngoscopic view, the time to intubation, and the incidence ofany complications were recorded as well.
Results:
Eleven patients were included in each group without any exclusion from the study. The cervical vertebral angle changes pre- and post-intubation with the MGL was less than with the Macintosh laryngoscope at C3/4 (2.00 vs. 4.27 degrees, respectively; p-value = 0.034) and the cumulative changes of all cervical spine levels (9.18 vs. 17.18 degrees, respectively; p-value = 0.017). However, the time to intubation with the MGL was longer (35.07 vs. 23.21 seconds, p-value = 0.004), the laryngoscope view was better. There were no statistically significant differences in the intubation success rate, the number of attempts, and the incidence of complications.
Conclusion:
Orotracheal intubation with MGL provided less cervical spine motion and improved visualization of the vocal cords, without causing adverse consequences as compared with Macintosh laryngoscope and MILS.
Insights
McGrath series 5 videolaryngoscope (MGL) reduces cervical spine motion during intubation compared to the Macintosh laryngoscope. This videolaryngoscope offers improved visualization without adverse effects, enhancing patient safety in suspected cervical spine injury.
Area of Science:
- Anesthesiology
- Emergency Medicine
- Neurosurgery
Background:
- Cervical spine injury necessitates cautious intubation to prevent neurological damage.
- Videolaryngoscopes are emerging as tools to minimize cervical spine movement during intubation.
Purpose of the Study:
- To compare cervical spine movement during orotracheal intubation using the McGrath series 5 videolaryngoscope (MGL) versus the conventional Macintosh laryngoscope.
- To evaluate intubation success, time, view, and complications associated with each device.
Main Methods:
- A randomized study of 22 patients undergoing elective orthopedic surgery with manual in-line stabilization (MILS).
- Patients were intubated using either MGL (n=11) or Macintosh laryngoscope (n=11).
- Cinefluoroscopy measured cervical vertebral angle changes; intubation attempts, view, time, and complications were recorded.
Main Results:
- MGL resulted in significantly less cervical spine motion at C3/4 (2.00 vs. 4.27 degrees) and cumulatively (9.18 vs. 17.18 degrees) compared to Macintosh.
- MGL provided better laryngoscopic view but required longer intubation time (35.07 vs. 23.21 seconds).
- No significant differences were found in success rates, number of attempts, or complications.
Conclusions:
- Orotracheal intubation with MGL minimizes cervical spine motion and enhances vocal cord visualization compared to the Macintosh laryngoscope with MILS.
- The MGL is a safe alternative, showing no adverse consequences and offering improved visualization.
Related Concept Videos
01:30Cardiopulmonary Resuscitation V: Advanced Airway Management Techniques
01:22Cardiopulmonary Resuscitation II: ACLS Airway Management
01:28Endoscopic Procedures III: Video Capsule Endoscopy