The Lateral Spinothalamic Pathway is an ascending spinal tract, carrying sensory information to the brain. It is typically depicted as a chain of three neurons: first-, second-, and third-order neurons.

This pathway mediates sensation of pain and temperature.

The first-order neurons in the pathway are located in the dorsal root ganglia at all spinal levels. Their axons ascend the tract of Lissauer, and synapse with second-order neurons.

The second-order neurons are located in the dorsal horn, and their axons immediately decussate via the ventral white commissure. These axons ascend the lateral funiculus and project to the ventral posterolateral (VPL) nucleus of the thalamus.

Some collaterals are sent to areas involved in arousal, namely the midbrain reticular formation, and the intralaminar nuclei of the thalamus (which then project to the caudatoputamen, and frontal and parietal cortex).

The third-order VPL neurons send axons through the posterior limb of the internal capsule to the somatosensory cortex (areas 3, 1, 2).

Lesions to the Lateral Spinothalamic Pathway

Spinal cord lesions affecting the Lateral Spinothalamic pathway result in contralateral sensory deficits below the lesion, because the pathway immediately decussates at the second-order neuron level.

Ventral Spinothalamic Pathway

There is also a Ventral Spinothalamic Pathway, that carries crude touch sensation. It is organized very similarly to the Lateral Spinothalamic pathway; however, it is less clinically-emphasized since the Dorsal Column Medial Lemniscus pathway is more important for touch sensation. If the Ventral Spinothalamic pathway is lesioned, touch sensation will only be minimally affected, as long as the dorsal column remains intact.