Is the Spinal CORD Located at the Coccyx?

Patients sometimes ask me whether the “spinal cord” is located at their coccyx.

It’s a reasonable question, since the spinal cord does extend through most of the human spine.

What is the Spinal Cord?
  • The spinal cord is a dense, relatively tightly packed collection of nerves.
  • The spinal cord is almost like a big, thick electrical cable, with lots of electrical wires (nerves) going through it.
  • But it’s more complicated because there is also a complex system of connections that work like relay switches (synapses), where electrical signals get turned on and off.
Where is the Spinal Cord and the Spinal Canal?
  • In general, the “spinal cord” itself goes from the base of the brain down to the upper lumbar region.
  • Usually the lowest part of the spinal cord is at about the level of the 1st or 2nd lumbar vertebral bone, which, for reference, would be a few inches ABOVE your belt line or waistband.
  • So, the spinal cord is relatively far away from the tailbone in the vast majority of patients.
  • (A small percentage of patients may have a spinal cord that is “tethered” down, sometimes seen in people with spina bifida, for example, but even then it would not be so far down that it would be expected to be down at the level of the coccyx).
  • However, the spinal CANAL extends downward through the sacrum.
  • The coccyx does NOT have a spinal cord within it, and the coccyx does NOT have a spinal canal within it.
The “Meninges” are “Lining” for the Spinal Canal
  • The walls on the inside of the spinal canal  are mostly made of spinal bones.
  • But there is a lining inside the bones. It’s sort of like the way that there is a plastic lining inside of the walls of a swimming pool. This lining keeps the spinal fluid from leaking out.
  • The lining of the spinal canal is called the “Meninges” or meningeal lining or meningeal layers. It includes the  dura mater, arachnoid mater, and pia mater .
  • The  meningeal lining is almost like Saran wrap or whatever you call plastic wrap in your part of the world
  • Although the coccyx does not have any spinal canal within it (unlike the rest of the human spine)… BUT… some of the meningeal fibers that line the spinal canal do extend down through the sacrum and a few of those fibers attach at the top of the coccyx. This is probably not clinically significant in the vast majority of patients, but it rare cases patients may have tension or tugging or tightness of those fibers, where movements or tightness at other levels of the spine may cause tension/tugging on the coccyx, and vice versa. It’s uncommon, but possible.
OTHER Nerves at the Coccyx
  • Since there is no spinal cord at the coccyx, does that mean that there are no at the coccyx region????  …… No! Definitely not!
  • There are lots of other nerves at the coccyx.
  • Examples include normal somatic nerve fibers that carry pain and other sensation from the coccyx and surrounding tissues.
  • The skin over the coccyx is innervated by nerves.
  • Importantly, the ganglion Impar is located at the level of the upper coccyx.
In summary, the spinal cord itself is NOT located at the coccyx. But other nerves ARE located at the coccyx.
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