The lower earlier houses the terminal end of the spinal cord and also mostly encloses the cauda equina—nerve roots that descend indigenous the spinal cord. The spinal cord and the cauda equina are delicate and important structures. The spinal canal formed by the lumbar vertebrae protects these frameworks by offering a strong, bony casing.
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Video: Lumbar Spine Anatomy
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Lumbar Spinal Cord
The spinal cord terminates in the lumbar spine. The exact suggest of termination varies amongst individuals; many commonly, the terminates at the level that the L1 or L2 vertebrae. A couple of anatomical structures regarded the lumbar spinal cord space highlighted below.
The terminal part of the spinal cord in the lumbar region is cone-shaped and is dubbed the conus medullaris.
The conus medullaris is comprised of number of neurons (nerve cells) and also has 3 protective layers. Beginning from the outermost layer, these space the dura mater, arachnoid mater, and also pia mater. The pia mater tapers and also continues under as the filum terminale in ~ the finish of the conus medullaris.1
The pia mater creates a delicate, fibrous strand the tissue referred to as the filum terminale the extends under from the conus medullaris. This strand stabilizes the spinal cord by connecting the conus medullaris to the coccyx (end of the spine).1
The dura mater and also arachnoid mater are collectively called the dural sac or the thecal sac. This sac consist of the conus medullaris, cauda equina, and each individual spinal nerve root as it process out that the cauda equina and also travels into the intervertebral foramen (bony opening v which the nerve exits the spinal canal).2
The room inside the arachnoid mater is filled with cerebrospinal liquid (CSF). Listed below the conus medullaris, this an are is enlarged. This enlargement is referred to as the lumbar cistern and contains CSF, the filum terminale, and also the cauda equina.2
The Cauda Equina
A team of nerve root that take trip down native the spinal cord and also the conus medullaris is called the cauda equina. The cauda equina includes nerve roots from L2 in the lumbar spine come Co1 in the coccygeal (tail bone end) spine.1 every nerve source from the cauda equina exit the spinal canal in ~ its particular vertebral level, for example, the L4 nerve source exits in between the L4 and also L5 vertebrae.
In This Article:
Spinal Cord and Cauda Equina of the Lumbar Spine
Problems related to the Lumbar Spinal Cord and Cauda Equina
The terminal organization of the spinal cord in the lower back can acquire compressed, irritated, or abnormally stretched and typically reason serious medical problems. Feasible conditions influence this an ar along through the details symptoms, signs, and also causes are described below.
Cauda Equina Syndrome
The cauda equina is formed by the extension of nerve fibers beyond the spinal cord. Compression that the cauda equina, such together by a herniated disc, may cause severe pain and numbness in both legs. Read more about Cauda Equina Syndrome
Conus medullaris syndrome
Compression that the conus medullaris in the lumbar region at L1-L2 (typically between T12 to L2) reasons conus medullaris syndrome. This syndrome is defined by the following signs and also symptoms1:Sudden beginning of severe back painNumbness about the anal regionWeakness the occurs symmetrically in both legsSudden start of bowel and also bladder dysfunctionThe many common causes of conus medullaris syndrome encompass spinal fracture, disc herniation, tumors, trauma, and collection that pus in the epidural space due to infection (epidural abscess).1
Conus medullaris syndrome is a clinical emergency and requires immediate treatment to maintain leg function.
Tethered cord syndrome
An abnormal filum terminale can alter the security of the conus medullaris and also prevent the normal movement in the spinal canal. This problem is referred to as tethered cord syndrome and also causes the spinal cord to gain abnormally stretched, especially throughout actions such as spinal flexion (bending forward).1 typical signs and also symptoms include3:Urinary dysfunction: increased urination or retention of urineUrinary street infectionsBack pain, which is increased while bending the spine forward and also relieved while bending the neck backwardConstipation
While this condition is frequently identified during periods of rapid growth in adolescence, the symptoms may not occur until adulthood. Common reasons of tethered cord syndrome are separation spinal cord (diastematomyelia), spinal cord lining difficulties (dermal sinuses), and also lumps that fatty organization in the spinal cord region (lipomas).1
Cauda equina syndrome
Compression the the cauda equina in ~ the lumbar cistern can cause serious symptoms in the lower body. The problem is referred to as cauda equina syndrome and presents with the adhering to signs and symptoms4:Numbness that the within thighs (saddle anesthesia)Urinary retentionLoss that bowel and/or bladder controlSevere lower back painSciatica-like shooting and also burning pains in the leg(s)A emotion of pins-and-needles in the leg(s)
Cauda equina syndrome can existing in 2 ways: acute onset, where the symptoms and signs occur rapidly, and also insidious onset, wherein the condition begins as lower earlier pain and slowly progresses come bowel and urinary incontinence.4
Read more about Cauda Equina Syndrome symptom
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Cauda equina syndrome is most commonly caused through compression indigenous a lumbar herniated disc. Compression may likewise occur because of tumors, cysts, stenosis (abnormal narrowing that the spinal canal), or trauma. Cauda equina syndrome is a medical emergency. Instant treatment is crucial for the avoidance of paralysis and preservation of leg function.4
Read an ext about reasons of Cauda Equina Syndrome
If any of these spinal cord related problems are suspected, that is recipient to top a doctor immediately. Spinal cord disorders may be cure nonsurgically or surgically depending upon the cause and also the all at once health of the patient. The prognosis increases considerably when treated early.
See When earlier Pain might Be a medical Emergency