The Anatomy:

The spinal cord is a bundle of nervous tissue and supporting material that extends from the brain to innervate the rest of the body.  The brain and the spinal cord together form the central nervous system (CNS), which sends and receives messages from the body through the peripheral nervous system (PNS).

anatomyThe spinal cord is contained in the spinal canal formed by the vertebral column.  The meninges are a covering consisting of three layers that continues from the cranium to the sacrum and protects the spinal cord and its nerves.  The innermost layer, or pia mater, wraps around the brain and spinal cord.  The middle layer, or arachnoid mater, is a spider web-like layer.  The outermost layer is called the tough dura mater.  Between the arachnoid mater and the pia mater is ones cerebral spinal fluid (CSF) which protects and buffers the brain and spinal cord.  Outside of the three-layered meninges is the epidural space. 

The epidural space is a potential space that lies outside of the dura and typically houses protective fatty tissue and blood vessels.  The epidural space is where medications are placed for epidural blocks and where the leads are placed for spinal cord stimulation.


The spinal cord normally extends from the foramen magnum, a hole at the bottom of the cranium, to the L1 vertebra in adults.  In children the spinal cord ends at L3 and travels upward as they grow older.  Nerve roots exit from the back and front of the spinal cord and then join to form the spinal nerves from second cervical nerve root to the fifth sacral nerve root (C2 to S5).  The spinal nerves then leave the spinal canal through openings between each vertebra called the intervertebral foramen.
The main functions of the spinal cord are to relay signals from the brain to all muscles for movement, relay signals up from the body for sensory input, and to also coordinate reflexes.  Each spinal nerve root supplies sensory innervations to a specific area of skin called a dermatome.  Lesions of specific nerve roots result in predictable pattern of signs and symptoms.  For instance, a lesion in a lumbar nerve root may cause radiating pain, muscle weakness, numbness, tingling, and/or reflex changes in the legs.  This gives physicians a tool for localizing the lesion that is causing the symptoms.  Imaging modalities such as MRIs and diagnostic tools like EMGs (electromyography) may be used to assist and confirm a diagnosis.

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