SPINAL CORD and

SPINAL CORD TRACTS

Wencito A. Daya MD
Neurosurgery-Spine Surgeon
Fellow Academy of Filipino Neurosurgeons
Fellow Philippine Spine Society
Asst Training Officer
Southern Philippines Integrated Neurosurgical
Training Program (SPINTrP)
Conus medullaris

Cauda equina

Filum terminale
Conus medullaris

Cauda equina

Filum terminale
 Central Cord Syndrome
Greater weakness in the upper limbs
than in the lower limbs, occurs in
cervical region
The most common of the incomplete
syndromes
Frequently seen in elderly patients
with cervical stenosis
Good prognosis for recovery but age
a predictor:
<50 yo >50 yo
Ambulation 97% 41%
ADLs 77% 12%
Bowel 63% 24%
Bladder 83% 29%
 Central Cord Syndrome
Greater weakness in the upper limbs
than in the lower limbs, occurs in
cervical region
The most common of the incomplete
syndromes
Frequently seen in elderly patients
with cervical stenosis
Good prognosis for recovery but age
a predictor:
<50 yo >50 yo
Ambulation 97% 41%
ADLs 77% 12%
Bowel 63% 24%
Bladder 83% 29%
 Brown-Sequard Syndrome
2 - 4 % of all traumatic SCI
Hemi-section injury of the spinal cord
producing greater ipsilateral
proprioceptive & motor loss with
contralateral loss of pin &
temperature sensation
Overall best prognosis for recovery

Ambulation 75%(40% if >50 yo)

ADLs 70%
Bowel 82%
Bladder 89%
 Anterior Cord Syndrome

Injury involving anterior 2/3 of

spinal cord with variable loss
of motor function, pain &
temperature, with preserved
proprioception and light touch
Poor prognosis for recovery
only 10 20% have any motor
recovery and its almost
always non-functional
 Posterior Cord Syndrome

Least frequent
Preserves pain,
temperature, and light
touch with varying
degrees of motor
preservation and loss of
proprioception
Prognosis for ambulation
is poor
Reflexes
Babinski Clonus
Reflexes
Hoffmans Sign Inverted radial Reflex
Sub Axial Instrumentation
BHOLMAN wiring technique
5 years Post Op
5 years Post Op
5 years Post Op
6 years Post Op
6 years Post Op
6 years Post Op
Occipito-Cervical Fusion
Occiput

C2
 C4 Vertebral
Body Metastasis
C4 Corpectomy for Vertebral Body Mets
Head Part

C3-C6 Lateral mass screws,T1

Pedicle screws Fixation
C3-C6 Lateral mass
screws,T1 Pedicle
screws Fixation
Dens Fx type II Hangmans Fracture
Traumatic Translational Injury
AO type C Fx
Hartshill Rod Fixation
Hartshill Rod Fixation
TB Spondylitis T5-T9
Pedicle Screw Fixation T2-T12
Head
Laminectomy
and
Pedicle Screw
Fixation T2-
T12
SCOLIOSIS
SURGERY
THANK YOU