An Overview of Spinal Lesions

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Lesion is a general term for tissue that has been injured, destroyed, or otherwise has a problem. Spinal lesions affect the nervous tissue of the spine. They may be due to:

  • Cancerous or non-cancerous tumors
  • Trauma
  • Infection
  • Demyelinating disorders such as multiple sclerosis
  • Congenital defects

Symptoms and treatment depend on the spinal-lesion type and cause. Diagnostic testing includes imaging, especially with magnetic resonance imaging (MRI).

Doctor scrutinizes x-ray for lesions.
Dolgachov / Getty Images

Symptoms

Spinal lesions may have symptoms of non-specific back pain, or myofascial pain syndrome. You may not be able to pinpoint where your pain is coming from.

However, if the lesion affects the spinal nerve roots or spinal cord, you are likely to have nerve symptoms, which can include:

  • Weakness
  • Numbness
  • Tingling
  • Electrical shock-like feelings down one leg or arm
  • Difficulty with fine motor skills (such as writing) or with walking, balance, or coordination

The type of nerve symptoms will depend on where the lesion is located as well as the extent of the lesion.

In cases with infectious causes, you may have symptoms of infection, such as fever.

Serious symptoms that should be considered red flags include:

  • Bowel/bladder dysfunction (especially urinary retention)
  • Progressive neurologic weakness
  • Saddle anesthesia (loss of sensation only in the buttocks, perineum, and inner thighs)
  • Bilateral radiculopathy (pain, numbness, and weakness in the back and legs)
  • Incapacitating pain
  • Unrelenting night pain

Causes

Spinal lesions have a wide variety of causes.

According to the American Association of Neurological Surgeons, between 30% and 70% of people with cancer will have a bone metastasis to the spine, which can cause spinal lesions.

Diagnosis

The diagnostic process starts with a medical history to assess trauma and risks for spinal infection, cancer, and congenital malformations.

A physical exam will check for sensory and strength changes. Blood and urine tests may also be done to screen for underlying problems and general health.

If the symptoms point to underlying problems, you may be referred to imaging or to a specialist. Imaging can include X-rays and magnetic resonance imaging (MRI). A positron emission tomography (PET) scan might be used if a tumor is suspected.

In the case of tumors, your doctor may perform a biopsy to obtain a sample for examination under the microscope.

Treatment

Drainage or removal of lesions such as abscesses, cysts, and tumors will depend on your age and condition, as well as the size of the lesion and what structures it is affecting.

Surgical correction may be possible for some structural lesions or may be required if the lesion affects surrounding structures. Radiation, chemotherapy, or targeted therapies may be used for malignant or metastatic tumors.

Treatment of the underlying condition, such as with antibiotics or antivirals for infections, or disease-modifying therapies for multiple sclerosis, may also be necessary.

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

A Word From Verywell

If your doctor tells you that you have a spinal lesion, it simply means that there is evidence that may form the basis for further exploration of its cause. Consider the finding a notable clue that gets you closer to a complete diagnosis.

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  2. Rubin M. Overview of spinal cord disorders. Merck Manual Professional Version. Updated September, 2018.

  3. Dastagir A, Healy BC, Chua AS, et al. Brain and spinal cord MRI lesions in primary progressive vs. relapsing-remitting multiple sclerosis. eNeurologicalSci. 2018;12:42–46. doi:10.1016/j.ensci.2018.07.002

  4. American Association of Neurological Surgeons. Spinal tumors.