User:NickDupree/Luque Rods

Luque rods, "L"-rods, also known as segmental spinal instrumentation, developed by Dr. Eduardo Luque of Mexico City, Mexico, are a type of stainless steel spinal instrumentation consisting of a unique layout of sub-laminar wires that affix segments of vertebrae to two rods along the spinal column to treat scoliosis. By the mid-1980s, Luque rods increasingly began to replace Harrington rods as the spinal instrumentation of choice for the "surgical fixation and correction of scoliosis."

Purpose

Luque rods fuse to individual segments of the spine via their characteristic stainless-steel wires fitting behind the lamina, aided by extra bone grafted from the patient's pelvis, typically from the Iliac crest, and were increasingly adopted in place of the Harrington system because of the significant drop in the time necessary for a patient's fusion and recovery. With the Harrington rods commonly used prior, weeks or more of bed-rest and near-total patient immobility (with casts, braces, orthopedic frames—such as the Stryker frame—and/or traction) were usually required to achieve the proper spinal fusion. Unlike the Harrington instrumentation, which attaches to the spine's exterior (via hooks) and applies force along the length of the entire spine, the Luque system's double-rod instrumentation with wiring behind each vertebral lamina applies "transverse forces along the sections of vertebrae." This stabilizes the spine "internally," segment by segment, allowing for previously unattainable recovery times, such as with "Lori," an early 1984 case study of Luque spinal instrumentation in a 13 year old girl, documented by the American Journal of Nursing as "out of bed and walking in a week, while patients with Harrington rods are kept immobile."

Post-operative course

Immediate post-operative care, with "Lori" as with most spinal instrumentation surgeries, includes a central line, arterial line, a Foley catheter and Hemovac drainage systems placed in the primary back wounds. "Lori" spent 36 hours after surgery in intensive care before being transferred to the adolescent unit.

References

• Living with cerebral palsy
• Medscape - Modern Posterior Thoracic Instrumentation
• - 20-year follow-up of Harrington instrumentation in the treatment of severe Idiopathic Scoliosis, Pecina & Dapic, European Spine Journal Vol 16 No 2 Feb 2007(subscription only)
• - Scoliosis Surgery: Flatback Syndrome and Surgery, by Baron S. Lonner MD, Director of Scoliosis Associates in New York