A case of airway obstruction after posterior occipito-cervical fusion

: A 62-year-old female with rheumatoid arthritis underwent posterior occipito-cervical fusion. Although the operation was successfully performed, airway obstruction developed immediately after the extubation. We succeed in fiberoptic intubation. We consider that airway obstruction was caused by the preexisting reduction of the pharyngeal space and the occipito-cervical fusion malalignment. On the extubation after occipito-cervical fusion, we should always consider the possibility of re-intubation and its difficulty.