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Adult spinal cord termination — FRCA Primary MCQ

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HardAnatomyAdult spinal cord terminationFRCA Primary

A spinal anaesthetic is planned at L3-L4 in an adult. The trainee asks why this level is chosen rather than a higher lumbar space. What is the best anatomical reason?

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Correct answer: A — The spinal cord usually ends around L1-L2

In adults, the spinal cord usually ends around L1-L2, so lower lumbar puncture reduces risk of cord injury. The dural sac extends to about S2, not L4. The cauda equina nerve roots are mobile within CSF and can move away from the needle. Paediatric anatomy differs because the cord extends relatively lower in neonates.

Reference: RCoA Primary FRCA Syllabus; Gray's Anatomy for Students