Luke's instrumentation

The Luke instrument is a segmental spinal fixation because it lacks support and is less used alone for the treatment of spinal fractures. It can only be used to treat translational injuries caused by violence perpendicular to the longitudinal axis of the spine, including Chance fractures. Treatment of diseases: spinal fractures Indication The Luke instrument is a segmental spinal fixation because it lacks support and is less used alone for the treatment of spinal fractures. Luke instrument fixation can only be used to treat vaginal translational injuries perpendicular to the longitudinal axis of the spine, including Chance fractures. Surgical procedure Incision and exposure The posterior median incision was taken. The length of the incision was from 3 spinous processes on the injured vertebra to the next 3 spinous processes. The skin, subcutaneous and supraspinous ligaments were dissected, and the sacral spine muscles were removed under the periosteum, and three spinous processes, lamina and articular processes were observed above and below the injured vertebrae. Surgery should be revealed from the vertebral body to the injured vertebrae, and the lamina of the fracture or dislocation should be carefully removed to prevent the periosteal stripper and the laminar fracture piece from entering the spinal canal. Remove clots, clear fractures of the spine, small joint displacement or interlocking, and interspinous ligament, ligament ligament rupture. 2. Reveal the lamina gap The thoracic vertebrae overlap each other, and the spinous process and part of the lower edge of the lamina should be bitten to reveal the interlaminar space. The lumbar vertebrae do not overlap, and the spinous process can be removed. If the difficulty is revealed, the lower part of the spinous process can be bitten off. . 3. Opening window between the lamina Use a sharp blade to remove or use a rongeur to bite the interspinous ligament and the ligamentum flavum, reveal epidural fat, adhesion between the dura mater and the lamina, separate with a nerve stripper, and then use a laminar to remove part of the lamina In the thoracic vertebrae, the inner part of the facet facet joint is to be bitten, so that the lamina is made into a bone window with a diameter of 5-8 mm. 4. Place the lower lamina wire It adopts double-strand 1mm thick steel wire, and can also use single-strand 1.2mm thick steel wire and 30~40mm long steel wire to fold it in half, so that the folded part is small ring or curved. When used for thoracic vertebra, small ring should be small, otherwise It is difficult to pass the spinal canal and it is easy to damage the spinal cord. The 4 to 5 cm of the folded end of the steel wire is bent into a semicircular shape, and the lamina is closely attached to the lamina from the lower edge of the lamina, and is passed under the lamina, and the end of the lamina is used to hook the end of the wire with a hook. The same method passes through the other side of the wire. When using a 1.2mm steel wire, the head end can be cut to form a single steel wire, one on each side. After the wire passes under the lamina, be sure to cross or twist the ends to the back side for 1 to 2 turns to avoid pressing the spinal cord forward. The remaining lamina wires are placed in turn. 5. Place the Luke stick Choose a proper length Luke rod, pre-fold according to the physiological curvature of the spine, and cut off too long. Separate one side of the wire and place the rod between them. The short end of the rod can pass through the base of the spinous process or the interspinous ligament, so that the long and short heads of the two rods are placed against each other to form a parallelogram, and the wire is tightened in turn to make the rod Close contact with the lamina to achieve a firm fixation. After tightening the wire, cut off the long wire. 6. Bone graft Before tying the Luke rod, the surface of the lamina can be removed from the cortex with a bone knife to form a rough surface. After the Luke rod is tied, the incision is flushed, and the tibia is cut at the back of the side and cut into strips, together with the cut. Spinous processes are implanted between the lamina and the spinous processes, and between the Luke rods and the small joints. Avoid inserting the window between the lamina. 7. Suture incision Rinse the incision, fully stop the bleeding, place the negative pressure drainage tube, and suture the incision layer by layer.