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The conus medullaris (Latin for "medullary cone") or conus terminalis is the tapered, lower end of the spinal cord. It occurs near lumbar vertebral levels 1 (L1) and 2 (L2), occasionally lower. [1] [2] The upper end of the conus medullaris is usually not well defined, however, its corresponding spinal cord segments are usually S1–S5.
Sectional organization of spinal cord. The spinal cord is the main pathway for information connecting the brain and peripheral nervous system. [3] [4] Much shorter than its protecting spinal column, the human spinal cord originates in the brainstem, passes through the foramen magnum, and continues through to the conus medullaris near the second lumbar vertebra before terminating in a fibrous ...
The filum terminale is situated centrally [2] amid the spinal nerve roots of the cauda equina [3] [2] (but is not itself a part of the cauda equina [2]).. The inferior-most spinal nerve, the coccygeal nerve, leaves the spinal cord at the level of the conus medullaris via respective vertebrae through their intervertebral foramina, superior to the filum terminale.
The conus medullaris (or lower termination of the spinal cord) normally terminates at or above the L1-2 disk space (where L1 is the first, or topmost lumbar vertebra). After about 3 months of age, a conus below the L1-2 disk space may indicate a tethered cord and termination below L3-4 is unmistakably tethered.
The lumbar enlargement (or lumbosacral enlargement) is a widened area of the spinal cord that gives attachment to the nerves which supply the lower limbs.. It commences about the level of T11 and ends at L2, and reaches its maximum circumference, of about 33 mm. Inferior to the lumbar enlargement is the conus medullaris.
It is the space within the thecal sac which extends from below the end of the spinal cord (the conus medularis), typically at the level of the first to second lumbar vertebrae down to tapering of the dura at the level of the second sacral vertebra. The dura is pierced with a needle during a lumbar puncture (spinal tap).
The conus medullaris (bottom of the spinal cord) terminates at the level of L1 in adults, but may range in term neonates (newly born babies) from L1–L3 levels. [31] It is important to insert the spinal needle below the conus medullaris at the L3/L4 or L4/L5 interspinous levels. [32]
The posterior median sulcus is the posterior end of the posterior median septum of neuroglia of the spinal cord. The septum varies in depth from 4 to 6 mm, but diminishes considerably in the lower part of the spinal cord.