THE MOTOR SYSTEM, SPINAL CORD INTERNAL STRUCTURE AND

CHAPTER III: IMPACT OF DIFFERENT LESIONS ON MOTOR AND SENSORY SYSTEMS

THE WHITE MATTER OF THE SPINAL CORD

The white matter is peripheral in position in the spinal cord. It surrounds the gray matter.
It is divided into (Fig. 1):

1- Posterior white column or funiculus: lies between the midline (posteromedial septum)
and the entry of the posterior nerve roots.
2- Lateral white column or funiculus: lies between the entrance of the posterior nerve
roots and the emergence of the anterior nerve roots.
3- Anterior white column or funiculus: lies between the point of emergence of the
anterior nerve roots and the antero-median fissure (midline)

Fig. 1: Parts of white matter of spinal cord

Structure of the white matter:

It is formed of myelinated nerve fibers, neuroglia and blood vessels (continuous non-
fenestrated). They are grouped together in bundles known as tracts.
The tract is a group of myelinated nerve fibers having the same origin, same course, same
termination and performs certain definite function.

I) Long tracts: II) Short tracts:

1) Ascending tracts:
A) Exteroceptive tracts 1) Comma shaped tract
B) Proprioceptive tracts 2) Septomarginal tract
3) Lissauer’s tract
2) Descending tracts: 4) Fasciculus proprius tract
A) Pyramidal tract
B) Extra-pyramidal tracts
 THE MOTOR SYSTEM, SPINAL CORD INTERNAL STRUCTURE AND
CHAPTER III: IMPACT OF DIFFERENT LESIONS ON MOTOR AND SENSORY SYSTEMS

1) Ascending tracts

A) Exteroceptive pathway (Fig. 2)

These are tracts that carry exteroceptive sensation as pain, temperature and crude touch
from the opposite side of the body to the sensory cortex.
1) Ventral spinothalamic tract → at ventral white column.
2) Lateral spinothalamic tract → at lateral white column.
Both are crossed tracts at anterior white commissure.
3) Spinotectal tract (at lateral white column) →carry afferent information for spinovisual
reflexes.

Fig. 2: Exteroceptive pathway

• Lesion of the lateral spinothalamic tract within the spinal cord produces
contralateral loss of pain and thermal sensation below the level of the lesion as it
crosses at anterior white commissure.

• Lesion of the ventral spinothalamic tract within the spinal cord produces
contralateral loss of light touch sensation below the level of lesion.
 THE MOTOR SYSTEM, SPINAL CORD INTERNAL STRUCTURE AND
CHAPTER III: IMPACT OF DIFFERENT LESIONS ON MOTOR AND SENSORY SYSTEMS

B) Proprioceptive pathway (Fig. 3):

1)Proprioceptive pathways that reach the conscious level (Cerebral cortex):
Gracile and cuneate tracts. They ascend at dorsal white column. They carry fine touch,
vibration and proprioceptive sensations from the body.
Gracile tract carries these sensations from the lower half of the body while the cuneate
tract carries sensations from the upper half of the body as it starts from T6 upwards.

• Lesion of the dorsal column in Tabes dorsalis (due to late stage of neurosyphilis)
markedly affects Gracile and cuneate tracts. The patient’s gait is affected due to
defective proprioception. This is due to progressive demyelination.

2)Proprioceptive pathways to the subconscious level (Cerebellum):

a) Dorsal spinocerebellar tract.
b) Ventral spinocerebellar tract.
c) Spino-olivary tract.
d) Cuneo-cerebellar tract.

Fig. 3: Proprioceptive Pathway

Unconscious proprioception is carried to the cerebellum as follows:

1) From 1st – 7th cervical segments, proprioception is carried by the cuneo-cerebellar

tract.
2) From 8th cervical segment to the 3rd lumbar segment (Clarke’s nucleus level),
proprioception is carried by the dorsal spinocerebellar tract.
3) Below the 3rd lumbar segment, some proprioceptive impulses ascend with gracile tract
till the Clarke’s nucleus, then it joins the dorsal spinocerebellar tract.
4) Proprioception from lumbar, sacral and coccygeal segments is carried by the ventral
spinocerebellar tract.
 THE MOTOR SYSTEM, SPINAL CORD INTERNAL STRUCTURE AND
CHAPTER III: IMPACT OF DIFFERENT LESIONS ON MOTOR AND SENSORY SYSTEMS

2) Descending tracts

They are divided into:

A) Pyramidal tract: which originates from the cerebral cortex. It descends as
corticospinal tracts (Fig. 4)
1- Lateral corticospinal tract: It descends in the lateral white funiculus of the
spinal cord and extends to the most caudal part of the cord and progressively
diminishes in size.

2- Ventral corticospinal tract: It descends in the anterior white column of the

spinal cord and extends only to the upper thoracic spinal cord levels and
innervates the axial muscles of the upper extremities and neck.

Fig. 4: Corticospinal tracts

A) Extrapyramidal tracts: that originate from the brain stem nuclei (Fig. 5).
1) Rubrospinal tract.
2) Tectospinal tract.
3) Vestibulo-spinal tract.
4) Reticulospinal tract (Medullary & Pontine)

❖ Medial longitudinal bundle: it descends in the ventral white column, where it forms
a well-defined bundle in the cervical region only.
 THE MOTOR SYSTEM, SPINAL CORD INTERNAL STRUCTURE AND
CHAPTER III: IMPACT OF DIFFERENT LESIONS ON MOTOR AND SENSORY SYSTEMS

Fig. 5: Extrapyramidal tracts

Table (1): showing site of long tracts in funiculi of the spinal cord.

Ascending Tracts Descending Tracts

Dorsal Column -Gracile (all spinal cord

segments)
-Cuneate (cervical & thoracic
segments till T6)
Lateral column -Dorsal spinocerebellar (C8—
L3) (Clarke's level)
-Ventral spinocerebellar
-Lateral spinothalamic
-Spino-olivary
-Spino-tectal
Ventral column -Ventral spinothalamic
-Lateral corticospinal
-Rubrospinal
-Medullary reticulospinal
-Ventral corticospinal (cervical &
thoracic segments till T6)
-MLB (cervical segments)
-Pontine reticulospinal
-Tectospinal (cervical segments)
-vestibulospinal
 THE MOTOR SYSTEM, SPINAL CORD INTERNAL STRUCTURE AND
CHAPTER III: IMPACT OF DIFFERENT LESIONS ON MOTOR AND SENSORY SYSTEMS

Anterior white commissure (Fig. 6)

-Lies in front of the gray commissure.
-It is the site of crossing of the spinothalamic tracts.
Clinical application:
• In syringomyelia (Dilatation of central canal) pressure affects the anterior white
commissure. It commonly affects the cervical segments. So, symptoms are related
to the spinothalamic tracts (pain, temperature & crude touch) while the dorsal
column is spared. In progressive lesions, motor effects could occur due to damage
of anterior horn cells or fibers of the corticospinal tract.

Fig. 6: Anterior white commissure

 THE MOTOR SYSTEM, SPINAL CORD INTERNAL STRUCTURE AND
CHAPTER III: IMPACT OF DIFFERENT LESIONS ON MOTOR AND SENSORY SYSTEMS

Short tracts of spinal cord

They are present within the spinal cord for its connections.
They are intersegmental and have associative and integrative functions.
They are subclassified as:
1-Association------connects the adjacent part of the same side
2-Commissural -------connects opposite halves of spinal cord

1- Comma shaped tract:

It Lies between gracile and cuneate tracts. Present only in the upper half of the spinal
cord.
It represents the descending fibers from cuneate tract.

2-Fasciculus proprius tract

It surrounds the gray matter of the spinal
cord. It originates and ends in the spinal
cord.
It interconnects the neurons at different
spinal levels (coordination).

3- Lissauer’s tract
It extends from the tip of the dorsal horn
to the surface of spinal cord. It contains:
a) Lateral division of the dorsal root of
spinal nerves.
b) Fibers that connect different levels of
substantia gelatinosa. Fig. 7: Short tracts
The fibers ascend and descend for few segments before
termination on spinal cord laminae.
• For: pain modulation.

4- Septomarginal tract: (Fig. 8)

It lies close to the dorsomedian septum in
the lower half of spinal cord between gracile
tracts. It represents the descending fibers
from the gracile tract.

Fig. 8: septomarginal tract