Segmental Arteries

The segmental arteries that make contributions to the anterior and posterior spinal arteries include (1) the vertebral and ascending cervical arteries in the neck, (2) the costocervical trunk and posterior intercostal arteries in the thorax, and (3) the lumbar, iliolumbar, and lateral sacral arteries in the abdomen and pelvis (Fig. 19). Spinal branches of the segmental arteries enter the intervertebral canal and divide further into two types of branches. Radicular branches distribute with and supply the anterior and posterior rootlets of the spinal nerves (Fig. 15). Segmental medullary branches (anterior and posterior) contribute to and reinforce the anterior and posterior spinal arteries and supply the cord itself. The segmental arteries also provide branches to the vertebral column (not shown in Fig. 15). Postcentral branches of the segmental arteries supply the posterior aspect of the vertebral bodies, and prelaminar branches supply the deep aspect of the vertebral arch.

The artery of Adamkiewicz is a spinal branch that makes a major contribution to the anterior spinal artery by supplying a large portion of the spinal cord including the lumbosacral enlargement (Fig. 19). Accurate localization of the artery is important when planning interventional radiologic treatment, and noninvasive methods of localization are particularly useful in patients with vascular disease. Recently, multidetector row helical computed tomography has been shown to depict the artery of Adamkiewicz in a higher percentage of patients when

Artery Adamkiewicz

Fig. 19. Formation of the anterior spinal artery and its reinforcement by branches of segmental arteries. The anterior spinal artery is formed superiorly by branches of the right and left vertebral arteries. At many vertebral levels, spinal branches of segmental arteries pass through the intervertebral foramina and reinforce the anterior spinal artery. The relatively constant artery of Adamkiewicz is a spinal branch of thoracic or lumbar segmental arteries. (Courtesy of Stephen G. Moon.)

Fig. 19. Formation of the anterior spinal artery and its reinforcement by branches of segmental arteries. The anterior spinal artery is formed superiorly by branches of the right and left vertebral arteries. At many vertebral levels, spinal branches of segmental arteries pass through the intervertebral foramina and reinforce the anterior spinal artery. The relatively constant artery of Adamkiewicz is a spinal branch of thoracic or lumbar segmental arteries. (Courtesy of Stephen G. Moon.)

compared to magnetic resonance imaging (17). Preoperative information on the location of the artery of Adamkiewicz may help reduce the risk of postoperative complications of spinal ischemia.

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