Anatomical study of the thoracolumbar radiculomedullary arteries, including the Adamkiewicz artery and supporting radiculomedullary arteries

Jorge E. Alvernia, Emile Simon, Krishnakant Khandelwal, Cara D. Ramos, Eddie Perkins, Patrick Kim, Patrick Mertens, Raffaella Messina, Gustavo Luzardo, Orlando Diaz

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

OBJECTIVE The aim of this paper was to identify and characterize all the segmental radiculomedullary arteries (RMAs) that supply the thoracic and lumbar spinal cord. METHODS All RMAs from T4 to L5 were studied systematically in 25 cadaveric specimens. The RMA with the greatest diameter in each specimen was termed the artery of Adamkiewicz (AKA). Other supporting RMAs were also identified and characterized. RESULTS A total of 27 AKAs were found in 25 specimens. Twenty-two AKAs (81%) originated from a left thoracic or a left lumbar radicular branch, and 5 (19%) arose from the right. Two specimens (8%) had two AKAs each: one specimen with two AKAs on the left side and the other specimen with one AKA on each side. Eight cadaveric specimens (32%) had 10 additional RMAs; among those, a single additional RMA was found in 6 specimens (75%), and 2 additional RMAs were found in each of the remaining 2 specimens (25%). Of those specimens with a single additional RMA, the supporting RMA was ipsilateral to the AKA in 5 specimens (83%) and contralateral in only 1 specimen (17%). The specimens containing 2 additional RMAs were all (100%) ipsilateral to their respective AKAs. CONCLUSIONS The segmental RMAs supplying the thoracic and lumbar spinal cord can be unilateral, bilateral, or multiple. Multiple AKAs or additional RMAs supplying a single anterior spinal artery are common and should be considered when dealing with the spinal cord at the thoracolumbar level.

Original languageEnglish (US)
Pages (from-to)233-241
Number of pages9
JournalJournal of Neurosurgery: Spine
Volume38
Issue number2
DOIs
StatePublished - Feb 1 2023

Keywords

  • anatomy
  • artery of Adamkiewicz
  • degenerative
  • hairpin turn
  • radiculomedullary artery

ASJC Scopus subject areas

  • Surgery
  • Neurology
  • Clinical Neurology

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