Thursday 28 March 2019

Do vertebral levels align with spinal cord levels?

Short answer: NO

Although the vertebral column is segmented into vertebral bodies and discs, true 'segments' probably don't exist in the spinal cord. Rootlets don't emerge from the spinal cord in bundles according to vertebral level (although, they do exit the vertebral column foramina in just such bundles as nerve roots), instead rootlets line the dorsal and ventral horns of the spinal cord in an un-segmented strip with an appearance much like the insertion of nylon hair on a plastic dolly's head (as beautifully demonstrated in this 2016 paper by Leijnse & D'Herde, https://doi.org/10.1111/joa.12493)


Despite these caveats, grand efforts have been made to work out the probabilistic correspondence between vertebral level and spinal cord level, an important task for those interested in attributing function or pathology to certain cord segments in vivo. Cadotte et al. 2015 (https://doi.org/10.3174/ajnr.A4192) have produced a wonderful paper with this aim in mind which includes some useful probabilistic maps (which, for those interested are integrated as part of the Spinal Cord Toolbox: https://sourceforge.net/p/spinalcordtoolbox/wiki/Spinal_levels/)

Long answer ...

Answer part 1: Cord 'segments' (defined by the approximate length of cord from which rootlets forming a single spinal root) emerge by definition with an offset from the vertebra they are named after (see Part 2). Furthermore, the offset between rootlet exit from the cord and root exit from the vertebral foramina (i) increases the further down the cord you look and (ii) varies amongst individuals.

Answer part 2: The naming convention of vertebral bodies and roots entails an offset between vertebral bodies and their root namesakes: cervical (neck) roots are always numbered according to the vertebra above which they emerges, e.g. the C2 root emerges between C1 and C2 and thus the C2 rootlets (and by implication the C2 cord 'segment') are likely, at least in part, to be in line with the C1 vertebra:



By convention, however, the root that emerges above the first thoracic (back) vertebra is named 'C8', and from anywhere below that level, roots are named according to the vertebra they emerge below:


This step change in nomenclature means that for a few of the upper thoracic verterbra, the cord rootlet exit zone for a numbered root is anatomically in line with the synonymous verterbra, i.e. the rootlets that merge to form the T1 root exit the cord at the same level as the T1 vertebra. (NB this is not shown on the figures, but the Spinal Cord Toolbox link above has a probability hotspot diagram that demonstrates this nicely).


Friday 11 January 2019

Why the blog?

Having searched and searched for interesting and reliable facts about the spinal cord (and brain - I don't deny its importance!), I came across a great website with a multitude of facts (https://faculty.washington.edu/chudler/facts.html#spinal - do check it out).

however

the ONE FACT I particularly sought: the number of neurons in the spinal cord, was listed but poorly referenced (and most probably incorrect by a magnitude of 10^2).

Indeed, I dug out the latest copy of Kalat's Biological Psychology, the source in question, and any allusion to the number of neurons in the spinal cord was GONE 😲(did they have second thoughts!?).

So, here is my own version of spinal cord facts and figures (and many other things cord related). And where better to start than with "How many neurons are there in the spinal cord?"?.*

A note on transparency and traceability:

The facts on this blog are intended to be as transparent and accurate as possible, so please comment wherever you think I've made a muck-up and provide a reference for the correction.

* The likely erroneous "billions" has been replicated on another apparently credible website, here: https://www.sapnamed.com/blog/10-surprising-facts-about-the-spinal-cord/

How many neurons are there in the human spinal cord?

A: approximately 18.5 million

43,000 neurons per millimeter spinal cord length

(Burish et al 2010, Brain Behav Evol 2010;76:45–59 https://doi.org/10.1159/000319019)

377 - 481 mm long

(Leo et al 2014, Spine. 39(4):E262-E269, doi: 10.1097/BRS.0000000000000125)

Total number of neurons: 43,000 x ~429 = 18,447,000

Why the blog?

Having searched and searched for interesting and reliable facts about the spinal cord (and brain - I don't deny its importance!), I came...