The Morel-Lavallée lesion revisited: Management in spinopelvic dissociation

Shah Nawaz M Dodwad, Steven R. Niedermeier, Elizabeth Yu, Tania A. Ferguson, Eric Otto Klineberg, Safdar N. Khan

Research output: Contribution to journalArticle

6 Scopus citations

Abstract

Background context The Morel-Lavallée lesion occurs from a compression and shear force that usually separates the skin and subcutaneous tissue from the underlying muscular fascia. A dead space is created that becomes filled with blood, liquefied fat, and lymphatic fluid from the shearing of vasculature and lymphatics. If not treated appropriately, these lesions can become infected, cause tissue necrosis, or form chronic seromas. Purpose To review appropriate identification and treatment of Morel-Lavallée lesions in spinopelvic dissociation patients. Study design Uncontrolled case series. Methods Retrospective review of medical records. No funding was received in support of this study. The authors report no conflicts of interest. Results We present four cases of patients with traumatic spinopelvic dissociation. All had concomitant lumbosacral Morel-Lavallée lesions. All four trauma patients suffered traumatic spinopelvic dissociation with concomitant lumbosacral Morel-Lavallée lesions. Appropriate treatment included irrigation and debridement, drainage, antibiotics, and vacuum-assisted wound closure. Conclusions Our series reflects an association of Morel-Lavallée lesion in spinopelvic dissociation trauma patients. Possibly, the rotatory injury that occurs at the spinopelvic junction creates a shear force to form the Morel-Lavallée lesion. When presented with a spinopelvic dissociation patient, one should be prepared to treat a Morel-Lavallée lesion.

Original languageEnglish (US)
Pages (from-to)e45-e51
JournalSpine Journal
Volume15
Issue number6
DOIs
StatePublished - Jun 1 2015

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Keywords

  • Infection
  • Morel-Lavallée lesion
  • Spine trauma
  • Spinopelvic disassociation

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Dodwad, S. N. M., Niedermeier, S. R., Yu, E., Ferguson, T. A., Klineberg, E. O., & Khan, S. N. (2015). The Morel-Lavallée lesion revisited: Management in spinopelvic dissociation. Spine Journal, 15(6), e45-e51. https://doi.org/10.1016/j.spinee.2013.08.023