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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.
The cauda equina (from Latin tail of horse) is a bundle of spinal nerves and spinal nerve rootlets, consisting of the second through fifth lumbar nerve pairs, the first through fifth sacral nerve pairs, and the coccygeal nerve, all of which arise from the lumbar enlargement and the conus medullaris of the spinal cord.
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.
Typically this is one of the first reflexes to return after spinal shock. Lack of motor and sensory function after the reflex has returned indicates complete SCI. Absence of this reflex in instances where spinal shock is not suspected could indicate a lesion or injury of the conus medullaris or sacral nerve roots. [citation needed]
A tethered cord is often diagnosed as a "low conus". 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 ...
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 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.
Between the two layers are spaces which exchange information with the subarachnoid cavity as well as blood vessels. At the point where the pia mater reaches the conus medullaris or medullary cone at the end of the spinal cord, the membrane extends as a thin filament called the filum terminale or terminal filum, contained within the lumbar cistern.