LESI MEDULA SPINALIS

Abstract

Spinal cord lesion is one of major causes of neurological disability due to trauma and non trauma. This disability can cause damage and loss of function below the level of lesion and also has adversed effects on several body systems. Traumatic spinal cord lesion is the most widely reported incidence compared to non traumatic spinal cord lesion. The most leading cause of traumatic spinal cord lesion is motor vehicle crash in children, whereas in old age, falls become the main cause. The mechanism of injury influences the type of spinal cord lesion and the degree of neurological deficit. Spinal cord lesions can be classified into complete and incomplete based on the presence or absence of a function that is maintained below the level of lesion. Complete spinal cord lesion shows absence of voluntary movement or sensation below the level of the lesion on both sides, whereas incomplete lesion shows the persistence of the variation of some functions below the level of lesion. Knowledge on the anatomy of the spinal cord plays an important role in the clinical diagnosis. The level of lesion at the different segments of the spinal cord determines different signs and symptoms, caused by destruction of segmental tissue and disconnection of ascending and descending tracts above and below the level of lesion. The level of lesion is helpful in predicting deficits of body functions that may occur, in determining the next treatment and in predicting the prognosis of the disease. Incomplete spinal cord lesion tends to have a better prognosis. Death usually occurs in lesion with multiple trauma. The leading cause of death is complications due to neurological disability, i.e. pneumonia, pulmonary embolism, septicemia, and renal failure.