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Good day, Once again I’m sorry for any delays in updating this blog. I will continue with my brief explanation of longitudinal levels of lesion. I understand that the following information may be dry. You may want to treat this section more as a reference area or glossary.
Receptor: The receptors of nerves are where the initial sensations of our environment into the nervous system occur. Our skin, joint, bones, organs, blood vessels all contain receptors that sense changes in stretch of tissues, heat, vibration, and chemical changes. There are also receptors on neuron cell membranes that have to do with cell communication. The cell membrane receptors are often the target of many of the medications being prescribed. Peripheral receptor lesions are rare but there are some like myasthenia gravis which can produce profound muscle fatigue. There are also theories of other autoimmune and toxic interference with the receptors. A massage stimulates stretch receptors in the muscles and skin. A chiropractic adjustment stimulates mechanoreceptors in joints, as well as it can stretch muscle spindle and Golgi tendon organs of the local muscles. The resetting of muscle spindles often helps to cause to more long lasting affects that you may notice with an adjustment. The upper cervical spine has the highest concentration of muscle spindles per area in the body.
Peripheral nerve: The peripheral nerves are the nerves between the body and brainstem or spinal cord. They can be divided into cranial nerves, spinal nerve roots, and the large groupings of spinal nerve roots that form larger nerves going into your arms and legs. Most nerves are made up of larger fibers that transmit information very fast like vibration, joint and muscle sensations, and smaller fibers that transmit information comparatively slow like heat and pain. Common indicators of peripheral nerve lesion are increased numbness, tingling, or pain and possibly muscle twitching or wasting. Many people have heard of common peripheral nerve lesions including disc herniations in the neck and lower back affecting the arms or legs, carpal tunnel syndrome, sciatica, etc. The list can go on for anywhere there is a nerve being compressed. The nerves are also very susceptible to loss of blood flow, toxicity, and low oxygen levels. One of the interesting findings with nerve compression is that it is usually the large fibers that become compressed and stop working first. The large fibers natural inhibit pain sensations at the level of the spinal cord. This is one of the reasons that people often only sense pain or have very intense/extreme pain. Other conditions that can affect peripheral nerves other that direct compression or trauma include the ever common diabetes, drugs, heavy metals, peripheral circulation problems, chronic inflammatory conditions. The most common reasons however for peripheral nerve lesions are the ones often seen by your Doctor of chiropractic including direct compression and or entrapment from a subluxated joint, arthritic bone spur, disc herniation, and hypertonic/shortened musculature.
Spinal cord: The spinal cord is the area of the central nervous system running from the base of the skull to about L1-L2 vertebra level. It lies inside the central canal of the spine. It is comprised of groups of neurons and tracts of nerve fibers with higher areas of the brain and brainstem. There are many reflexes that occur at this level including to usual deep tendon reflexes such as the knee jerk you may have experience with a chiropractic or medical exam. This is last area of convergence of the brain, cerebellum, and brainstem onto the ventral horn cells. The ventral horn cells are the neurons that fire into the peripheral nerves eventually to all the muscles of the body. Common findings of spinal cord lesions are weakness and spasticity. You might have a very tight but weak leg or arm. Reflexes are also increased. The most common reason for spinal cord lesions is due to injury. The extent of disability is dependent on the degree of spinal cord injury. Those with complete injuries are often quadriplegic or paraplegic. Many injuries are more on one side making them more difficult to diagnose. One of the most common reasons for compression of the spinal cord is severe osteoarthritis in the neck. This will often result in severe weakness of the legs and or bladder dysfunction which may be the main complaint. The arthritis causes bone spurs that diminish the space of the spinal canal. Increased diameter of veins in the spinal canal can also put pressure on the cord. The increased vein diameter can often be improved by increasing higher levels of the brain reducing constriction of the arteries; another reason for a full neurologic exam. Some people who have established spinal cord injuries and still have some use below the injury site can still benefit from chiropractic neurology care. By increasing to firing of the brain they can increase the firing of any residual nerve tracts making them more efficient. The most important job of the chiropractic neurologist lies here by influencing what does work to work even better.
Dr. Patrick Levesque DC DACNB

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