Artery of Adamkiewicz

Artery of Adamkiewicz CT scan OsiriX

Artery of Adamkiewicz (also known as the great anterior radiculomedullary artery or arteria radicularis magna) is a critical blood vessel that supplies oxygenated blood to the lower two-thirds of the spinal cord. Named after the Polish pathologist Albert Adamkiewicz who discovered it in the 19th century, this artery plays a vital role in the vascular system of the spinal cord. Its significance lies in its contribution to the anterior spinal artery, which is essential for the functional integrity of the spinal cord.

Anatomy

The Artery of Adamkiewicz typically arises from a left posterior intercostal artery between the T9 and T12 levels of the vertebrae, but it can originate anywhere from T5 to L2. Its origin is highly variable, making it a subject of interest in both clinical and surgical settings. After its origin, it ascends to enter the spinal canal through an intervertebral foramen and then joins the anterior spinal artery, contributing significantly to the blood supply of the lower spinal cord.

Clinical Significance

The artery's importance is underscored in procedures that risk compromising spinal cord blood flow, such as aortic aneurysm repair and thoracoabdominal aortic surgery. Accidental damage to the Artery of Adamkiewicz can result in anterior spinal artery syndrome, leading to paralysis or sensory loss due to ischemia of the spinal cord. Preoperative identification of the artery using magnetic resonance angiography (MRA) or computed tomography angiography (CTA) can help minimize surgical risks.

Variability and Identification

The high variability in the origin of the Artery of Adamkiewicz poses challenges for its identification and preservation during surgical procedures. Advanced imaging techniques, such as MRA and CTA, have improved the ability to visualize this artery preoperatively, thereby aiding in surgical planning and reducing the risk of spinal cord ischemia.

Conclusion

The Artery of Adamkiewicz is a crucial component of the spinal cord's vascular system, with significant implications for surgical and clinical practices. Its variability and importance in supplying blood to the lower spinal cord make it a critical focus in surgeries involving the thoracic and abdominal aorta. Understanding and preserving this artery is essential for preventing potentially devastating complications related to spinal cord blood supply.