Unstable Cervical Spine Posterior Fusion

You are required to anaesthetise a 75-year-old woman undergoing a posterior C1 – 2 fusion after a low-velocity mechanical fall at home yesterday evening. Her only injury is a mildly displaced type II dens fracture which has resulted in posterior neck pain and mild left hand weakness. She is currently immobilised in a hard cervical collar. She weighs 52 kg and is 155 cm tall. Her observations are within normal limits. Her relevant active comorbidity is osteoporosis managed with a bisphosphonate. She lives alone and is independent in her activities of daily living. A colleague has performed a preoperative review. The airway comments are: Thin face with minimal cheek tissue Mallampati 2, mouth opening 3 cm Thyromental distance 3 cm Upper partial plate (removable), lower natural dentition Neck extension not assessed Previous GA in 2020: Grade II, MAC 3. No comment on bag mask ventilation