Anaesthesia management of anterior cervical discectomy and fusion

Anterior Cervical Discectomy and Fusion (ACDF) is a common surgical procedure with positive outcomes, but it is not without potentially serious complications for the patient. We present the case of a patient who underwent ACDF and was found to have a cervical swelling prior to extubation. After a joint evaluation with the otolaryngology team, a suspicion of laryngeal structure dislocation was raised. A manual repositioning was performed prior to neuromuscular relaxation, and the patient was transferred intubated to the Recovery Unit due to a high risk of upper airway obstruction secondary to edema. After 24 h of monitoring under scheduled corticosteroid treatment, a planned and safe extubation was carried out, witnessed by the otolaryngology team.