Lesion

Definition

Doctor scrutinizes x-ray for lesions.
Lesions often show up of x-rays and other films.. Syda_Productions

Lesion Definition

Lesion is a general term used in medicine to refer to a pathology of tissue. It indicates an area of tissue that has been injured, destroyed, altered (for the worse) or otherwise has a problem.

Lesions exist in all medicinal specialties, with a wide variety of types that run the gamut from cancerous to non-cancerous, from large to small, serious or minor, as well as other criteria.

Lesions can also be classified according to their characteristics including pattern or location, or they may be named for the doctor or other person who first described it.

 

In other words, when your doctor tells you that you have a lesion, it simply means "something's going on" that may form the basis for further exploration and/or treatment.

Lesions of the Spine

According to Weisberg, Garcia and Strub, in their book Essentials of Clinical Neurology:  Lesions of the Spine and Spinal Cord, neck and back lesions, along with those affecting the spinal cord can be categorized in three ways, which are called clinical pictures or clinical syndromes:  Back pain or myofascial syndromes, nerve root symptoms, or radiculopathy, and spinal cord symptoms, called myelopathy.  Each of these categories are further broken down.

Lesions Relating to Myofascial Back Pain

Back pain, or myofascial syndrome, is by far and away the most common type of spinal lesion, making up about 80% of all cases, according to Weisberg and colleagues.

 This type of lesion is also called "non-specific back pain," which means pinpointing the exact location or abnormality responsible for the pain is not possible.

With this type of back lesion, you'll likely not get nerve symptoms, i.e., weakness, numbness, tingling and/or electrical shock going down one leg or arm.

The good news about non-specific low back pain is that it generally doesn't require imaging. Goertz, and colleagues, in their guideline for physicians who see low back patients (entitled "Adult acute and subacute low back pain") recommends that imaging for adults aged 18 or older with non-specific low back pain be "reduced or eliminated."

If you don't have nerve symptoms, and you suspect your doctor's recommendation to have films taken is not in line with evidence-based guidelines (as summarized above,) please speak up.  Ask her why she thinks films are necessary, and also try to find out what if any, business or financial association she has with the facility that will do the tests.  Then make your own decision, or at least get a 2nd opinion.

Back Lesions - More Information

    The other 20 or so percent of neck or back lesions can often be identified on a film.  These include root lesions and spinal cord lesions. 

    Root Lesions

    Root lesions include sciatica, conus medullaris syndrome (which is a termination of the spinal cord leading to numbness at the bottom of your feet, weakness of your gastroc muscle, lack of ankle reflexes, and saddle amnesia,) lumbar spinal stenosis, and disc disease.

    Root Lesions - More Information

    Spinal Cord Lesions

    Spinal cord lesions mainly consist of congenital and acquired diseases or conditions such as spina bifida, multiple sclerosis, and infections. Chronic progressive myelopathy is another type of spinal cord lesions.  In this condition arthritis or degenerative disc disease manifest myelopathy, which is nerve symptoms arising from the spinal cord.

    Sources:

    Goertz M, Thorson D, Bonsell J, Bonte B, Campbell R, Haake B, Johnson K, Kramer C, Mueller B, Peterson S, Setterlund L, Timming R. Adult acute and subacute low back pain. Bloomington (MN): Institute for Clinical Systems Improvement (ICSI); 2012 Nov.http://www.guideline.gov/content.aspx?id=39319&search=spine+pain+diagnostic+imagin#Section420

    LA Weisberg, C Garcia, R Strub. Essentials of Clinical Neurology: Lesions of the Spine and Spinal Cord. Tulane University website. Accessed September 2015. http://tulane.edu/som/departments/neurology/programs/clerkship/upload/wch19.pdf

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