Contiguous Lower Lumbar Fracture-dislocation plus Morel-Lavallee Lesion

Abstract

Background: Burst fractures constitutes up to one-fifth of spinal fractures. The mechanism of injury is axial compressive force. Additional forces may be involved, like flexion, extension and rotation. The thoraco-lumbar junction is the area commonly involved. Neurological injury occurs in 8% to 18% of cases. Multiple burst fractures occur in about 10% of cases and about 53% of these are non-contiguous. Contiguous burst fracture-dislocations of the lower lumbar spine are very rare: one case has been reported so far.
Case Report: We report a case of a young female who sustained a  contiguous fracturedislocation in the lumbo-sacral area plus extensive closed degloving injury of the spine. The mechanism of injury was a direct force. A computed tomography scan showed burst fractures of the lower lumbar spine. Magnetic Resonance Imaging demonstrated mechanical
compression of the cauda equina. Fracture-dislocations were confirmed intra-operatively. Decompression, posterior fixation and bone-grafting were done. Post-operative recovery was uneventful. She made full neurological recovery within a year.

Keywords: contiguous, burst, lumbar, dislocation, Morel-Lavallee.