What Are Spinal Cord Lesions? Causes and Symptoms
Spinal cord lesions are areas of damage or abnormality that disrupt nerve signals between the brain and body, resulting in various neurological symptoms. The spinal cord is a primary communication pathway for the central nervous system.
The Spinal Cord’s Role
The spinal cord is a long, tube-like structure extending from the brainstem to the lower back, protected by the spinal column.
Its primary function is to transmit sensory and motor electrical signals between the brain and peripheral nerves. Sensory signals relay touch, temperature, and pain to the brain, while motor signals instruct muscles. It also mediates rapid, involuntary reflexes without direct brain input.
Common Causes of Lesions
Spinal cord lesions stem from various conditions. Traumatic injuries (e.g., motor vehicle accidents, falls, sports, violence) are frequent causes, leading to compression, stretching, or tearing of spinal cord tissue. Infections, such as transverse myelitis (spinal cord inflammation), also form lesions.
Inflammatory conditions, where the immune system attacks its own tissues, are a cause. Multiple sclerosis (MS) involves demyelination, damaging nerve fiber coverings and leading to lesions. Tumors (cancerous or non-cancerous) develop within or near the spinal cord, compressing or invading nerve tissue. Vascular issues, like spinal cord infarction (a spinal cord stroke), occur when interrupted blood flow deprives oxygen.
Impact on Body Function
Symptoms depend on lesion location and damage extent. Cervical (neck) lesions can affect arms, trunk, and legs, causing quadriplegia. Thoracic (chest) damage impacts trunk and legs, resulting in paraplegia. Lumbar (lower back) or sacral (pelvic) lesions affect legs, bladder, and bowel control.
Sensory changes like numbness, tingling, or sensation loss below the lesion level are common. Altered pain perception or exaggerated responses to stimuli can occur. Motor function is impaired, from weakness to complete paralysis, affecting walking, grasping, or breathing, depending on severity and location.
Beyond sensory and motor deficits, spinal cord lesions disrupt autonomic functions (involuntary bodily processes). This leads to bladder and bowel control difficulties, causing incontinence or retention. Temperature regulation can be compromised, making it challenging to maintain a stable internal temperature. Blood pressure regulation can be affected, leading to dangerously low or high episodes, especially with higher-level lesions.
Diagnosis and Management
Diagnosis begins with a thorough neurological examination. A healthcare provider assesses motor strength, sensory perception, reflexes, and coordination to pinpoint the lesion’s location and severity. Imaging techniques confirm its presence. Magnetic resonance imaging (MRI) is often preferred, providing detailed soft tissue images and revealing inflammation, tumors, or demyelination.
Computed tomography (CT) scans are also used, especially in trauma cases, to visualize bone injuries or fractures compressing the spinal cord. Electrophysiological studies, like evoked potentials, can measure nerve signal transmission speed.
Management approaches are individualized, focusing on maximizing function and improving quality of life. Acute care often involves stabilizing the patient and preventing further injury.
Rehabilitation is a key part of management, including physical therapy to regain strength and mobility, and occupational therapy to adapt to daily activities. Symptom management addresses pain, spasticity, and bladder dysfunction through medication or other interventions. Supportive care includes psychological support and assistive devices to maintain independence. The overall goal is to facilitate recovery and adaptation, enabling individuals to live as fully as possible.