An Overview of Spinal Lesions

A spinal lesion describes any area of abnormal tissue on the spinal cord, whether it is benign (non-cancerous) or malignant (cancerous). Also known as a central lesion because of its impact on the central nervous system, spinal lesions have many different causes and, depending on their location, can cause different neurological (nerve-related) symptoms.

This article looks at the possible symptoms and causes of spinal lesions and provides an overview of how spinal lesions are commonly diagnosed and treated.

Symptoms

Spinal lesions can cause different symptoms depending on their location on the spinal cord as well as the lesion type and cause. There may be problems with motor skills and abilities. Some people experience chronic pain, while others may have a loss of certain bodily functions due to the blockage or interruption of nerve signals.

Among the possible symptoms of a spinal cord lesion are:

• Pain
  
• Numbness
• Tingling, prickly, or burning sensation
• Electrical shock-like sensations
• Muscle weakness
• Muscle stiffness
• Difficulty with fine motor skills (such as writing)
• Problem with balance or coordination
• Loss of reflexes or overactive reflexes
• Muscle spasms
• Changes in sexual function
• Loss of bowel or bladder control
• Difficulty breathing
  
• Paralysis

Causes

A lesion is an abnormal change caused by a disease or injury that affects any tissue or organ. Spinal lesions have a wide variety of possible causes, including:

• Trauma, including car accidents or severe falls
• Infections including polio, meningitis, tertiary syphilis, and HIV
  
• Benign tumors
• Cancer, either primary or metastatic
• Autoimmune diseases like multiple sclerosis (MS)
• Inflammatory diseases like spinal sarcoidosis and transverse myelitis
• Vascular disorders like spinal cord infarction
• Degenerative disorders like spinal stenosis and degenerative disc disease
• Congenital malformations such as spina bifida or scoliosis

Diagnosis

The diagnosis of a spinal lesion typically begins when a lesion is spotted on an X-ray or other imaging test. In addition to a physical exam and a review of your medical history, a neurological exam will be performed to check for any abnormalities in your reflexes, sensations, strength, and coordination.

Based on the findings, other tests may be performed to narrow the possible causes. These may include:

• Blood and urine tests to look for signs of infection, inflammation, or disease
• Imaging studies, including computed tomography (CT), or magnetic resonance imaging (MRI)
• Myelography to look for problems in the spinal canal
• Lumbar puncture (spinal tap) to obtain cerebrospinal fluid (CSF) for evaluation
• Spinal tumor biopsy to investigate for cancer

Treatment

The treatment of a spinal lesion varies by the underlying cause. Among the examples:

• Infections may be treated with antibiotics, antifungals, or antiviral drugs.
• Inflammatory conditions may be treated with anti-inflammatory drugs, steroids, or immunosuppressant drugs.
• Autoimmune diseases may also be treated with immunosuppressants and disease-modifying therapies.
• Cancer may be treated with surgical resection (removal), radiation, chemotherapy, and targeted therapies. Benign tumors may require resection.
• Degenerative or congenital conditions may benefit from spinal surgery.
  

Physical therapy may be able to help restore function after treatment and initial recovery.

Summary

A spinal lesion is an abnormal change caused by a disease or injury that affects tissues of the spinal cord. Symptoms include pain, abnormal sensations, loss of motor skills or coordination, or the loss of certain bodily functions. Causes include trauma, infection, autoimmune diseases, inflammatory diseases, spinal degeneration, congenital malformations, and benign or cancerous tumors.

Spinal lesions are commonly spotted on imaging tests. Based on the suspected cause, the doctor may perform a neurological exam, various blood or urine tests, additional imaging tests, a spinal tap, or a tumor biopsy. The treatment varies by the diagnosed causes.