Spinal Cord Anatomy and Localization

Todd A. Hardy, PhD, MBBS, FRACP Spinal Cord Disorders p. 12-29 February 2021, Vol.27, No.1 doi: 10.1212/CON.0000000000000899
REVIEW ARTICLES
BROWSE ARTICLES
Article as PDF
-- Select an option --

PURPOSE OF REVIEW This article focuses on clinically relevant teaching points in spinal anatomy and localizing the lesion in myelopathy.

RECENT FINDINGS The principles underlying spinal cord lesion localization are well established, but improvements in MRI and the discovery of pathologic antibodies associated with causes of transverse myelitis distinct from multiple sclerosis, such as aquaporin-4 IgG and myelin oligodendrocyte glycoprotein IgG, have assisted in diagnosis.

SUMMARY The spinal cord has a highly organized neuroanatomy of ascending and descending tracts that convey sensory, motor, and autonomic information. Using integration of clues from the patient’s history and neurologic examination, the effective clinician can distinguish spinal cord from peripheral nerve or brain pathology, often determine the level and parts of the spinal cord affected by a lesion, and focus on a likely diagnosis. The advent of MRI of the spine has revolutionized investigation of spinal cord disorders, but an important place for strong clinical acumen still exists in assessing the patient with a myelopathy.

Address correspondence to Dr Todd A. Hardy, Department of Neurology, Concord Repatriation General Hospital, Hospital Road, Concord, NSW 2139, Australia, [email protected].

RELATIONSHIP DISCLOSURE: Dr Hardy serves as coeditor of Advances in Clinical Neuroscience and Rehabilitation and on an advisory board for Merck & Co, Inc. Dr Hardy has received personal compensation for speaking engagements from Biogen; Merck & Co, Inc; Novartis AG; Sanofi Genzyme; and Teva Pharmaceutical Industries Ltd and research/grant support from Novartis AG.

UNLABELED USE OF PRODUCTS/INVESTIGATIONAL USE DISCLOSURE: Dr Hardy reports no disclosure.

© 2021 American Academy of Neurology.