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 Cervical spine injury, whether due to trauma, previous cervical fusion resulting in limited mobility, or inflammation from rheumatoid arthritis can present challenges for airway management. The presence of a cervical collar can also make airway management difficult. Evaluation of cervical flexion and extension is prudent, and, in the case of trauma, discussions with spine surgeons regarding cervical spine stability should take place.

 In the setting of an unstable cervical spine injury, intubation with a fiberoptic bronchoscope should take place. Alternatively, direct laryngoscopy while an assistant performs inline stabilization (holding the head firmly with both hands so as to not allow unintentional cervical flexion or extension by the laryngoscopist) may be attempted.