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The central canal (also known as spinal foramen or ependymal canal) is the
cerebrospinal fluid Cerebrospinal fluid (CSF) is a clear, colorless body fluid found within the tissue that surrounds the brain and spinal cord of all vertebrates. CSF is produced by specialised ependymal cells in the choroid plexus of the ventricles of the b ...
-filled space that runs through the
spinal cord The spinal cord is a long, thin, tubular structure made up of nervous tissue, which extends from the medulla oblongata in the brainstem to the lumbar region of the vertebral column (backbone). The backbone encloses the central canal of the spin ...
. The central canal lies below and is connected to the
ventricular system The ventricular system is a set of four interconnected cavities known as cerebral ventricles in the brain. Within each ventricle is a region of choroid plexus which produces the circulating cerebrospinal fluid (CSF). The ventricular system is c ...
of the brain, from which it receives cerebrospinal fluid, and shares the same
ependyma The ependyma is the thin neuroepithelial ( simple columnar ciliated epithelium) lining of the ventricular system of the brain and the central canal of the spinal cord. The ependyma is one of the four types of neuroglia in the central nervous syst ...
l lining. The central canal helps to transport nutrients to the spinal cord as well as protect it by cushioning the impact of a force when the spine is affected. The central canal represents the adult remainder of the central cavity of the
neural tube In the developing chordate (including vertebrates), the neural tube is the embryonic precursor to the central nervous system, which is made up of the brain and spinal cord. The neural groove gradually deepens as the neural fold become elevated, ...
. It generally occludes (closes off) with age.


Structure

The central canal below at the
ventricular system The ventricular system is a set of four interconnected cavities known as cerebral ventricles in the brain. Within each ventricle is a region of choroid plexus which produces the circulating cerebrospinal fluid (CSF). The ventricular system is c ...
of the brain, beginning at a region called the
obex OBEX (abbreviation of OBject EXchange, also termed IrOBEX) is a communications protocol that facilitates the exchange of binary objects between devices. It is maintained by the Infrared Data Association but has also been adopted by the Bluetooth S ...
where the
fourth ventricle The fourth ventricle is one of the four connected fluid-filled cavities within the human brain. These cavities, known collectively as the ventricular system, consist of the left and right lateral ventricles, the third ventricle, and the fourth ve ...
, a cavity present in the brainstem, narrows. The central canal is located in the third of the spinal cord in the
cervical In anatomy, cervical is an adjective that has two meanings: # of or pertaining to any neck. # of or pertaining to the female cervix: i.e., the ''neck'' of the uterus. *Commonly used medical phrases involving the neck are **cervical collar **cervic ...
and
thoracic The thorax or chest is a part of the anatomy of humans, mammals, and other tetrapod animals located between the neck and the abdomen. In insects, crustaceans, and the extinct trilobites, the thorax is one of the three main divisions of the crea ...
regions. In the
lumbar spine The lumbar vertebrae are, in human anatomy, the five vertebrae between the rib cage and the pelvis. They are the largest segments of the vertebral column and are characterized by the absence of the foramen transversarium within the transverse ...
it enlarges and is located more centrally. At the
conus medullaris ''Conus'' is a genus of predatory sea snails, or cone snails, marine gastropod mollusks in the family Conidae.Bouchet, P.; Gofas, S. (2015). Conus Linnaeus, 1758. In: MolluscaBase (2015). Accessed through: World Register of Marine Species at ...
, where the spinal cord tapers, it is located more ly.


Terminal ventricle

The terminal ventricle (ventriculus terminalis, fifth ventricle or ampulla caudalis) is the widest part of the central canal of the
spinal cord The spinal cord is a long, thin, tubular structure made up of nervous tissue, which extends from the medulla oblongata in the brainstem to the lumbar region of the vertebral column (backbone). The backbone encloses the central canal of the spin ...
that is located at or near the
conus medullaris ''Conus'' is a genus of predatory sea snails, or cone snails, marine gastropod mollusks in the family Conidae.Bouchet, P.; Gofas, S. (2015). Conus Linnaeus, 1758. In: MolluscaBase (2015). Accessed through: World Register of Marine Species at ...
. It was described by Stilling in 1859 and Krause in 1875. Krause introduced the term fifth ventricle after observation of normal
ependymal cells The ependyma is the thin neuroepithelial ( simple columnar ciliated epithelium) lining of the ventricular system of the brain and the central canal of the spinal cord. The ependyma is one of the four types of neuroglia in the central nervous sys ...
. The central canal expands as a fusiform terminal ventricle, and approximately 8–10 mm in length in the conus medullaris (or conus terminalis). Although the terminal ventricle is visible in the fetus and children, it is usually absent in adults. Sometimes, the terminal ventricle is observed by
MRI Magnetic resonance imaging (MRI) is a medical imaging technique used in radiology to form pictures of the anatomy and the physiological processes of the body. MRI scanners use strong magnetic fields, magnetic field gradients, and radio waves ...
or
ultrasound Ultrasound is sound waves with frequencies higher than the upper audible limit of human hearing. Ultrasound is not different from "normal" (audible) sound in its physical properties, except that humans cannot hear it. This limit varies ...
in children less than 5 years old.


Microanatomy

The central canal shares the same
ependyma The ependyma is the thin neuroepithelial ( simple columnar ciliated epithelium) lining of the ventricular system of the brain and the central canal of the spinal cord. The ependyma is one of the four types of neuroglia in the central nervous syst ...
l lining as the ventricular system of the brain. The canal is lined by ciliated, column-shaped cells, outside of which is a band of gelatinous substance, called the substantia gelatinosa centralis (or central gelatinous substance of spinal cord). This gelatinous substance consists mainly of
neuroglia Glia, also called glial cells (gliocytes) or neuroglia, are non-neuronal cells in the central nervous system ( brain and spinal cord) and the peripheral nervous system that do not produce electrical impulses. They maintain homeostasis, form ...
, but contains a few nerve cells and fibers; it is traversed by processes from the deep ends of the columnar ciliated cells which line the central canal. The
substantia gelatinosa of Rolando The apex of the posterior grey column, one of the three grey columns of the spinal cord, is capped by a V-shaped or crescentic mass of translucent, gelatinous neuroglia, termed the substantia gelatinosa of Rolando (or SGR) (or gelatinous substanc ...
is located more dorsally.


Development

The central canal represents the adult remainder of the central cavity of the
neural tube In the developing chordate (including vertebrates), the neural tube is the embryonic precursor to the central nervous system, which is made up of the brain and spinal cord. The neural groove gradually deepens as the neural fold become elevated, ...
. It generally occludes (closes off) with age.


Function

The central canal carries
cerebrospinal fluid Cerebrospinal fluid (CSF) is a clear, colorless body fluid found within the tissue that surrounds the brain and spinal cord of all vertebrates. CSF is produced by specialised ependymal cells in the choroid plexus of the ventricles of the b ...
(CSF), which it receives from the
ventricular system The ventricular system is a set of four interconnected cavities known as cerebral ventricles in the brain. Within each ventricle is a region of choroid plexus which produces the circulating cerebrospinal fluid (CSF). The ventricular system is c ...
of the brain. The central canal helps to transport nutrients to the spinal cord as well as protect it by cushioning the impact of a force when the spine is affected.


Clinical significance

Syringomyelia Syringomyelia is a generic term referring to a disorder in which a cyst or cavity forms within the spinal cord. Often, syringomyelia is used as a generic term before an etiology is determined. This cyst, called a syrinx, can expand and elongate o ...
is a disease caused by the blockage of the central canal. Blockage of the central canal usually occurs at the lower cervical and upper thoracic levels. This typically damages
white matter White matter refers to areas of the central nervous system (CNS) that are mainly made up of myelinated axons, also called tracts. Long thought to be passive tissue, white matter affects learning and brain functions, modulating the distributio ...
fibers that cross in
anterior white commissure The anterior white commissure (ventral white commissure) is a bundle of nerve fibers which cross the midline of the spinal cord just anterior (in front of) to the gray commissure ( Rexed lamina X). A delta fibers (Aδ fibers) and C fibers car ...
, leading to the loss of temperature, pain, and motor function at the affected levels on side opposite to the damage. Other relevant conditions include: *
Spina bifida Spina bifida (Latin for 'split spine'; SB) is a birth defect in which there is incomplete closing of the spine and the membranes around the spinal cord during early development in pregnancy. There are three main types: spina bifida occulta, m ...
*
Arnold-Chiari syndrome Chiari malformation (CM) is a structural defect in the cerebellum, characterized by a downward displacement of one or both cerebellar tonsils through the foramen magnum (the opening at the base of the skull). CMs can cause headaches, difficulty ...
*
Spinal tumor Spinal tumors are neoplasms located in either the vertebral column or the spinal cord. There are three main types of spinal tumors classified based on their location: extradural and intradural (intradural-intramedullary and intradural-extramedulla ...
*
Myelomeningocele Spina bifida (Latin for 'split spine'; SB) is a birth defect in which there is incomplete closing of the spine and the membranes around the spinal cord during early development in pregnancy. There are three main types: spina bifida occulta, m ...
*
Syringomyelia Syringomyelia is a generic term referring to a disorder in which a cyst or cavity forms within the spinal cord. Often, syringomyelia is used as a generic term before an etiology is determined. This cyst, called a syrinx, can expand and elongate o ...
*
Hydromyelia Syringomyelia is a generic term referring to a disorder in which a cyst or cavity forms within the spinal cord. Often, syringomyelia is used as a generic term before an etiology is determined. This cyst, called a syrinx, can expand and elongate o ...
. In hydromyelia, a dilation of the central canal of the spinal cord is caused by an increase of cerebrospinal fluid. *
Syringohydromyelia Syringomyelia is a generic term referring to a disorder in which a cyst or cavity forms within the spinal cord. Often, syringomyelia is used as a generic term before an etiology is determined. This cyst, called a syrinx, can expand and elongate ...
(i.e., both Syringomyelia and Hydromyelia) *
Tethered cord Tethered cord syndrome (TCS) refers to a group of neurological disorders that relate to malformations of the spinal cord.Spinal cord Ventricular system Tomsick T, Peak E, Wang L: Fluid-Signal Structures in the Cervical Spinal Cord on MRI: Anterior Median Fissure vs. Central Canal. AJNR 2017; 38:840–45 Tomsick T, Wang L, Zuccarello M, Ringer AJ. Fluid-signal structures in the cervical spinal cord on MRI in Chiari patients: Central canal or anterior median fissure? AJNR Am J Neuroradiol. 2021 Apr;42(4):801-806. doi: 10.3174/ajnr.A7046. Epub 2021 Mar 11.PMID: 33707286