Dorsal Horn

cornu posterius medullae spinalis

The dorsal (posterior) horn is the back part of the H-shaped grey matter of the spinal cord. It is the main sensory processing area, receiving pain, temperature, itch and touch signals from the dorsal roots. It is a key site where pain signals can be amplified or dampened before they travel to the brain.

Anatomical Data

Structure & Connections

Location	Posterior part of the spinal grey matter at every cord level, reaching toward the dorsolateral sulcus where the dorsal roots enter
Parts	Marginal zone (lamina I) Substantia gelatinosa (lamina II) Nucleus proprius (laminae III-IV) Laminae V-VI Nucleus dorsalis (Clarke column, T1-L2) Dorsolateral tract (Lissauer tract)
Connections	Dorsal roots and dorsal root ganglia Spinothalamic tracts (output) Spinocerebellar tracts (from Clarke column) Descending pain-modulating fibres from the raphe and locus coeruleus Ventral horn (reflex interneurons)
Blood Supply	Posterior spinal arteries; Anterior spinal artery (deep parts)

Biomechanics

Function & Actions

Receives and processes incoming sensory information, especially pain and temperature, and relays it to the brain and to reflex circuits.

Clinical Relevance

Clinical Notes

Changes in the dorsal horn after injury (central sensitisation) contribute to chronic pain conditions where light touch becomes painful. Shingles damages the dorsal root ganglion and dorsal horn, sometimes leaving postherpetic neuralgia. Many pain treatments, such as opioids, gabapentinoids and spinal cord stimulation, act at the dorsal horn.

Pathology

Common Injuries & Conditions

Central Sensitisation

Increased excitability of dorsal horn neurons after injury, causing pain to spread and normally harmless stimuli to feel painful.

Postherpetic Neuralgia

Persistent burning pain in a dermatome after shingles, linked to damage of the dorsal root ganglion and dorsal horn.

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