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Kwon, Kim, Kim, and Rhyu: The Tip Level of the Conus Medullaris by Magnetic Resonance Imaging and Cadaver Studies in Korean Adults
Original Article

Korean J Phys Anthropol 2016;29(2):47-51.

Published online: 20 January 2016

DOI: https://doi.org/10.11637/kjpa.2016.29.2.47

The Tip Level of the Conus Medullaris by Magnetic Resonance Imaging and Cadaver Studies in Korean Adults

Soonwook Kwon1, Tae Sik Kim1, Hyung Soo Kim2, Im Joo Rhyu1

1Department of Anatomy, Korea University College of Medicine

2Department of Radiology, Wonkwang University College of Medicine

Received 19 May 2016       Revised 21 June 2016       Accepted 22 June 2016

Copyright © 2016 Korean Association of Physical Anthropologists

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The spinal cord is part of the central nervous system, and its caudal end is named as the conus medullaris. Many researchers have reported the tip level of the conus medullaris by magnetic resonance imaging studies; others by cadaver dissection. The tip level of magnetic resonance imaging studies seemed to be higher than that of cadaver studies.
We evaluated the tip level the conus medullaris with magnetic resonance imaging and cadaver dissection in Korean adult population. MR data were scanned with T1-weighted, mid-sagittal magnetic resonance imaging of 248 living persons (mean age, 42.3±16.0 years; range, 12–85 years) and cadaver data were collected by dissections of 118 cadavers (mean age, 56.0±14.9 years; range, 16–94 years). The mean level of conus tip was found to be at the middle third of 1st lumbar vertebra (range, lower third T12 – lower third L2) from magnetic resonance imaging study and the upper third of 2nd lumbar vertebra (range, lower third T12 – lower third L3) from cadaver dissection study. The tip level of conus medullaris from magnetic resonance imaging study was higher than that from cadaver dissection study (p<0.05).

Keywords: Spinal cord, Vertebra, MRI, Korean

References

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Fig. 1.
The vertebral body and intervertebral disc were divided into the equal portions in MRI image (A) and cadaver dissection (B). The arrow head indicates the tip level of the conus medullaris.
kjpa-29-47f1.tif
Table 1.
Comparison of the tip level of the conus medullaris in different populations.
Method Population Average tip level Authors (publication year)
MRI American L1 (mean) Wilson and Prince (1989)
MRI British L1 lower third (mean) Saifuddin et al. (1998)
MRI Turkey T12-L1 intervertebral disc (mode) Demiryurek et al. (2002)
MRI Korean L1 lower third (median) Kim et al. (2003)
MRI Korean∗ L1 middle third (mean)∗  
Cadaver Thai L1-L2 intervertebral disc (mean) between upper border of L1 and L2 (mode) Boonpirak et al. (1994)
Cadaver White McCotter (1916)
Cadaver American L1 lower third – L2 upper third (mode) Needle (1935)
Cadaver American L1-L2 intervertebral disc (?) (mean) Reimann and Anson (1944)
Cadaver Japanese L2 upper third (mean) Hara (1987)
Cadaver Korean∗ L2 upper third (mean)∗  

∗ this study

Table 2.
Distribution level of tip of the conus medullaris based on MRI and cadaver studies.
Vertebral level MRI study Cadaver study
Number % Number %
lower third T12 1 0.5 2 1.7
Disc T12-L1 28 13.3 8 6.8
upper third L1 32 15.2 6 5.1
middle third L1 52 24.8 11 9.3
lower third L1 45 21.4 11 9.3
Disc L1-L2 34 16.2 16 14
upper third L2 6 2.9 23 19
middle third L2 9 4.3 14 12
lower third L2 3 1.4 10 8.5
Disc L2-L3 – – 11 9.3
upper third L3 – – 1 0.8
middle third L3 – – 4 3.4
middle third L3
lower third L3		 –
-		 –
-		 4
1		 3.4
0.8
Total 210 100% 118 100%
Mean level of conus tip L1 middle third∗ L2 upper third∗

∗ P<0.05

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