Artery of Adamkiewicz: Medullary Artery or Radicular Artery?

Abstract

The artery of Adamkiewicz (A of A), after Albert Adamkiewicz (1882–1921) provides 75–80% blood supply to the spinal cord by way of the anterior spinal artery. Haller in 1754, described this vessel in “Iconum Anatomicarum”, but did not name it. This artery, the “magnus ramus radicularis anterior” or “arteria magna spinalis”, is interpreted as the greater radicular artery. Recently, it has been recognized by other anatomical terms.From the intercostal a., a spinal a. enters the neural foramen and penetrates the dural root sheath as a radicular a., a medullary a. or both. Consequently, the radicular aa. supply the nerve roots (L. radix, root), and the medullary aa. supplement the anterior spinal a. (75%) while the posterior medullary a. supplement the posterior spinal aa. Contributions to the nerve root by the medullary aa. is minimal.It has been known for decades the medullary a. supplements the spinal cord and not the radicular a. Anatomical knowledge of (A of A) and its correlation with the intercostal aa. is essential in the prevention of postoperative neurosurgical/cardiovascular procedures, i.e. paraplegia.PurposeClarify arterial structures of the spinal cord, and emphasize anatomical relationships of (A of A).MethodExtensive literature search, dissection and consultation with both basic science and clinical faculty.