Plate 2-6 Spinal Cord: Anatomy and Myelopathies

Sections through spinal cord at various levels

Posterior median sulcus

Posterior intermediate sulcus Lateral horn of gray matter
Posterior lateral sulcus (intermediolateral nucleus)
White matter
Gelatinous
substance

Gray matter
Posterior horn
Commissure
Anterior horn
Anterior lateral sulcus C5 Anterior T2 T8
white
Anterior median fissure commissure

PRINCIPAL FIBER TRACTS

OF S PINAL CORD

The spinal cord consists of a core of gray matter, sur-

rounded by an outer fiber layer, the white matter. The L1 L2 S2 S3
gray matter consists of the cell bodies and dendrites of
spinal neurons and the axons and axon terminals issuing
from them or ending upon them (see Section 1, Normal Principal fiber tracts of spinal cord
and Abnormal Development, in Part I). The white
matter consists of the axons of longitudinally running
fiber tracts. The outlines of the gray and white matter Ascending pathways
are different at different spinal levels (Plate 2-6). The Descending pathways
white matter is relatively massive in the cervical region Fibers passing in both directions
and declines progressively in bulk in the lower levels.
The gray matter is most highly developed in the cervi- Septomarginal fasciculus (oval bundle)
cal and lumbar enlargements, where it is made up of Hệ thống Bó thon
the neurons involved in the sensory and motor func- cột sau Bó chêm Interfascicular (semilunar) fasciculus
tions of the arms and the legs.
The schematic cross section in the lower part of the Posterolateral fasciculus Lateral corticospinal
illustration shows the location of the principal fiber (tract of Lissauer) (pyramidal) tract
tracts within the spinal white matter. As indicated by
the colors, the tracts can be divided into ascending Posterior spino- Rubrospinal tract
(blue) and descending (red) pathways linking the spinal cerebellar tract
cord with the brain, and propriospinal (purple) path- Medullary (lateral)
ways made up of fibers interconnecting different levels reticulospinal tract
within the spinal cord itself. Anterior spino-
The ascending pathways include the fasciculus gracilis cerebellar tract Pontine-
and fasciculus cuneatus (part of the medial lemniscus Anterolateral reticulospinal (medial
system), which convey fine discriminative sensation system (ALS) includes reticulospinal) tract
from the lower and upper parts of the body, respec- spinothalamic, Vestibulospinal tract
tively. Less discriminative, higher-threshold sensations spinoreticular,
are carried by the anterior and lateral spinothalamic tracts; spinomesencephalic Anterior cortico-
the latter is particularly important in conveying the (spinotectal), and spinal tract
sensations of pain and temperature. Other ascending spinohypothalamic fibers
pathways, which are more closely involved in reflex Tectospinal tract
activity and motor control, include the posterior and Spinoolivary tract
anterior spinocerebellar tracts and the spino-olivary, spino- Fasciculi proprii Medial longitudinal (sulcomarginal) fasciculi
tectal, and spinoreticular tracts.
The descending pathways are divided into two groups.
The first group includes the corticospinal tracts and the
rubrospinal tract. It terminates preferentially in the pos- the medial longitudinal fasciculus and terminates prefer- spinal cord via the posterior roots and then ascend or
terolateral regions of the spinal cord, which contain the entially in the anteromedial regions of the spinal cord. descend in the oval bundle, comma tract, posterolateral
neurons controlling the distal muscles of the limbs. These regions contain the neurons controlling axial and fasciculus (of Lissauer), fasciculus gracilis, or fasciculus cune-
Damage to these pathways results in loss of fine- proximal limb muscles and regulate posture and right- atus to terminate on spinal neurons at other levels of
fractionated control of the extremities. The second ing. In addition to their motor action, both sets of the spinal cord. Other propriospinal fibers originate
group includes the anterior and lateral reticulospinal descending pathways also include fibers that modulate from interneurons in the spinal gray matter itself. Col-
tracts, the tectospinal tract, the lateral and medial vestibu- sensory transmission by spinal pathways. lectively, propriospinal fibers are important in mediat-
lospinal tracts, and the interstitiospinal tract (from the Propriospinal Pathways. Some of the propriospinal ing spinal reflexes and coordinating activity at different
interstitial nucleus of Cajal and pretectal area) that runs in pathways consist of afferent fibers, which enter the levels of the spinal cord.

THE NETTER COLLECTION OF MEDICAL ILLUSTRATIONS 55