Overview
Lesions of the spinal cord can result from various etiologies including trauma, tumors, infections, and demyelinating diseases, leading to diverse neurological deficits depending on the location and severity of the lesion 1.Diagnosis
Clinical Assessment: Evaluation of neurological deficits (motor, sensory, autonomic) 1.
Imaging Studies: MRI is essential for identifying the nature and extent of spinal cord lesions 1.
Electrophysiological Tests: Nerve conduction studies and somatosensory/motor evoked potentials may help assess the level and severity of cord involvement 1.Management
Surgical Intervention: Indicated for compressive lesions like tumors or hematomas, aiming to decompress the spinal cord 1.
Thermal Ablation: Utilized for certain lesions, with peripheral nerve electrostimulation as an adjunctive monitoring technique to prevent thermal injury 1.
Supportive Care: Includes physical therapy, pain management, and management of complications such as spasticity 1.Special Populations
Pregnancy: Specific considerations for imaging modalities and treatment options to minimize fetal risk are crucial but not detailed in the provided abstracts 1.
Pediatrics: Tailored approaches for imaging and intervention are necessary due to developing spinal structures, though specifics are not covered here 1.
Elderly: Increased risk of comorbidities necessitates careful assessment and individualized treatment plans, though detailed guidance is not provided 1.Key Recommendations
Utilize peripheral nerve electrostimulation during percutaneous thermal ablation procedures to monitor and prevent iatrogenic neurologic injury (Evidence: Moderate) 1.
Employ MRI for definitive diagnosis and assessment of spinal cord lesions (Evidence: Strong) 1.
Consider surgical decompression for compressive spinal cord lesions to prevent further neurological deterioration (Evidence: Moderate) 1.References
1 Tsoumakidou G, Garnon J, Ramamurthy N, Buy X, Gangi A. Interest of electrostimulation of peripheral motor nerves during percutaneous thermal ablation. Cardiovascular and interventional radiology 2013. link