Spinal Cord Anatomy: Internal Structure and Tracts

Complete tutorial on spinal cord anatomy - white matter columns, gray matter nuclei, ascending (sensory) and descending (motor) tracts, blood supply, and segmental organization.

This content is for informational purposes only. Always consult a healthcare professional.

The spinal cord is the major neural pathway between the brain and the body. It extends from the foramen magnum to the L1-L2 vertebral level in adults.

Gross Anatomy

External Features

Feature Description
Length ~45 cm (adult)
Weight ~30 g
Segments 31 (8C, 12T, 5L, 5S, 1Co)
Enlargements Cervical (C4-T1), Lumbar (T9-T12)
Termination Conus medullaris (L1-L2 in adults, L3 in newborns)
Filum terminale Pial extension to coccyx
Cauda equina Lumbar/sacral nerve roots below conus

Meninges

Layer Description Spaces
Dura mater Thick fibrous tube Epidural space (fat, veins), Subdural space (potential)
Arachnoid mater Delicate avascular Subarachnoid space (CSF, vessels)
Pia mater Vascular, adherent to cord Denticulate ligaments (stabilize cord)

Nerve Roots

  • Ventral roots: Motor (efferent) - exit via anterior lateral sulcus
  • Dorsal roots: Sensory (afferent) - enter via posterior lateral sulcus
  • Dorsal root ganglion: Sensory neuron cell bodies
  • Spinal nerve: Mixed (sensory + motor)

Internal Structure

Gray Matter

The gray matter is H-shaped or butterfly-shaped, divided into horns:

Horn Location Contents Function
Dorsal (posterior) Dorsal Sensory neurons, substantia gelatinosa Sensory processing
Ventral (anterior) Ventral Motor neurons (alpha, gamma) Motor output
Lateral (intermediate) Between dorsal and ventral (T1-L2, S2-S4) Preganglionic autonomic neurons Autonomic output
Central gray Around central canal Interneurons Pain modulation, supraspinal connections

Rexed Laminae

The spinal gray matter is organized into 10 laminae (I-X):

Lamina Location Nucleus/Nuclei Function
I Dorsal horn (marginal zone) Posteromarginal nucleus Pain, temperature
II Dorsal horn (substantia gelatinosa) Substantia gelatinosa Pain modulation
III-IV Dorsal horn (nucleus proprius) Nucleus proprius Touch, pressure
V Dorsal horn (neck) Reticular formation Sensory processing
VI Dorsal horn (base) Proprioception (cervical/lumbar only)
VII Intermediate zone Intermediolateral cell column (T1-L2), sacral autonomic, Clarke column (C8-L2), phrenic (C3-C5) Autonomic, proprioceptive relay
VIII Ventral horn (medial) Commissural interneurons Motor coordination
IX Ventral horn (lateral) Alpha and gamma motor neurons Motor output to skeletal muscle
X Around central canal Pain modulation

White Matter

The white matter is organized into three columns (funiculi):

Column Location Major Tracts
Dorsal column Between dorsal horns Fasciculus gracilis, fasciculus cuneatus
Lateral column Between dorsal and ventral horns Corticospinal, spinothalamic, spinocerebellar
Ventral column Between ventral horns Corticospinal (anterior), vestibulospinal, tectospinal

Ascending Tracts (Sensory)

Dorsal Column-Medial Lemniscus Pathway

Modality: Fine touch, vibration, proprioception (conscious)

Component Location Description
First-order neuron Dorsal root ganglion Peripheral → spinal cord
Fasciculus gracilis Dorsal column (medial) Lower body (T7 and below)
Fasciculus cuneatus Dorsal column (lateral) Upper body (T6 and above)
Second-order neuron Nucleus gracilis/cuneatus (medulla) Decussates (internal arcuate fibers)
Medial lemniscus Medulla → pons → midbrain Crossed fibers to thalamus
Third-order neuron VPL nucleus (thalamus) Thalamus → primary somatosensory cortex

Lesion: Ipsilateral loss of fine touch, vibration, and proprioception below the lesion

Spinothalamic Tract (Anterolateral System)

Modality: Pain, temperature, crude touch

Component Location Description
First-order neuron Dorsal root ganglion Peripheral → spinal cord
Second-order neuron Substantia gelatinosa/nucleus proprius Decussates within 1-2 segments via anterior commissure
Lateral spinothalamic Lateral column Pain and temperature
Anterior spinothalamic Ventral column Crude touch (controversial)
Third-order neuron VPL nucleus (thalamus) Thalamus → primary somatosensory cortex

Lesion: Contralateral loss of pain and temperature 1-2 segments below the lesion

Spinocerebellar Tracts

Modality: Unconscious proprioception (for coordination)

Tract Location Origin Termination
Dorsal spinocerebellar Lateral column (posterior) Clarke column (C8-L2) Cerebellum (ipsilateral, via ICP)
Ventral spinocerebellar Lateral column (anterior) Lamina VII (lumbar) Cerebellum (contralateral, via SCP)
Cuneocerebellar Lateral cuneate nucleus (medulla) Fasciculus cuneatus (upper body) Cerebellum (ipsilateral)
Rostral spinocerebellar Lateral column Cervical cord Cerebellum

Descending Tracts (Motor)

Corticospinal Tract (Pyramidal Tract)

Function: Voluntary fine motor control

Component Location Description
Origin Primary motor cortex (BA 4), premotor (BA 6) Upper motor neuron (UMN)
Corona radiata Cerebral white matter Converging fibers
Internal capsule Posterior limb Between caudate and putamen/thalamus
Cerebral peduncle Midbrain Middle 3/5 of crus cerebri
Pyramid Medulla Visible ventral ridge
Decussation Caudal medulla 85-90% of fibers cross
Lateral corticospinal Lateral column (crossed) To all spinal levels
Anterior corticospinal Ventral column (uncrossed) To cervical/upper thoracic
Termination Lamina IX (anterior horn) Synapse on lower motor neuron

Lesion: Contralateral spastic paralysis, hyperreflexia, Babinski sign (UMN signs)

Extrapyramidal (Indirect) Motor Tracts

Tract Origin Function Location in Cord
Rubrospinal Red nucleus (midbrain) Flexor tone Lateral column (anterior to corticospinal)
Vestibulospinal (lateral) Lateral vestibular nucleus Extensor tone, balance Ventral column
Vestibulospinal (medial) Medial vestibular nucleus Head position Ventral column
Reticulospinal (pontine) Pontine RF Facilitates motor activity Ventral column
Reticulospinal (medullary) Medullary RF Inhibits motor activity Lateral column
Tectospinal Superior colliculus Head/eye reflexes Ventral column

Blood Supply

Arterial Supply

Artery Origin Territory
Anterior spinal artery Vertebral arteries (intracranial) Anterior 2/3 of spinal cord
Posterior spinal arteries (2) Vertebral or PICA Posterior 1/3 (dorsal columns)
Radicular arteries Segmental arteries (vertebral, intercostal, lumbar, sacral) Supplement spinal arteries
Artery of Adamkiewicz (great anterior radicular) Intercostal or lumbar (left, T8-L2) Lower 2/3 of spinal cord

Vulnerable zones:

  • Watershed zone T3-T4 (between cervical and thoracic radicular supply)
  • Artery of Adamkiewicz territory (critical for lower cord)

Venous Drainage

Vein Description
Anterior spinal vein Along anterior median fissure
Posterior spinal veins Along posterior lateral sulci
Radicular veins Drain to internal vertebral venous plexus
Internal vertebral venous plexus (Batson plexus) Valveless, connects pelvic to spinal veins

Spinal Cord Syndromes

Syndrome Lesion Findings
Brown-Sequard (hemisection) Half of cord Ipsilateral UMN weakness, loss of vibration/proprioception; contralateral loss of pain/temperature
Anterior cord Anterior spinal artery occlusion Bilateral UMN weakness, loss of pain/temperature; preserved vibration/proprioception
Central cord Syringomyelia, trauma Bilateral loss of pain/temperature in upper extremities (suspended sensory level); variable motor
Posterior cord Tabes dorsalis Loss of vibration and proprioception; sensory ataxia; positive Romberg
Complete cord transection All tracts Bilateral UMN weakness below level, loss of all sensation, autonomic dysfunction
Cauda equina Below conus (lumbar nerve roots) Lower motor neuron signs, radicular pain, bladder/bowel dysfunction
Conus medullaris S2-S4 level Early bladder/bowel dysfunction, saddle anesthesia; LMN signs