What is the primary risk to the spinal cord during Luque instrumentation?

The primary risk to the spinal cord during Luque instrumentation is related to the placement of sublaminar wires. In this surgical technique, sublaminar wires are used to secure the instrumentation to the vertebrae, allowing for stabilization of the spinal column. However, the placement of these wires carries the risk of direct injury to the spinal cord if not carefully executed.

When wires are positioned too deeply or improperly, they can come into contact with or penetrate the spinal cord, leading to potential neurological deficits or complications. This concern is particularly significant because the anatomy of the spinal cord in relation to the vertebrae can be complex, and the risk of injury can increase during the manipulation of the spine.

Other factors, such as excessive distraction, improper alignment, and de-rotation of the spine, can contribute to spinal cord risks but are typically secondary to the direct risks posed by the sublaminar wire placement. Thus, the focus on the proper technique for sublaminar wire placement is paramount in mitigating the risk of spinal cord injury during these procedures.