The fifth thoracic dorsal spinal rami run posteriorly, adjacent to the zygapophyseal joints between T5 and T6 and divide into medial and lateral branches.

The lateral branches emerge between the superior costotransverse ligaments and the intertransversarii muscles and pass between the longissimus thoracis and iliocostalis cervicis muscles to reach the medial border of levatores costarum.

Supply
The lateral branches of the fifth thoracic dorsal spinal rami supply the multifidus, longissimus thoracis, iliocostalis cervicis, levatores costarum and interspinales muscles; they may also supply skin via a cutaneous branch.