Radiculomedullary arterial contributions to the thoracolumbar spinal cord: an angiographic study.

Abstract

Anterior (ASA) and posterior spinal arteries (PSA) receive vital collateral flow from radiculomedullary (RM) arteries. The purpose of this study was to review a series of spinal angiograms in order to characterize normal RM arterial anatomy. The reports of digital subtraction spinal angiograms from consecutive patients from our institution from 2002-2019 were retrospectively reviewed. The RM contributions to both the ASA and PSA were characterized by noting laterality, spinal level and multiplicity. Overall, 336 spinal angiograms from 336 patients were included. Regarding RM input to the ASA, 328 patients (97.6%) had at least one RM contribution to the ASA. Forty-six patients (46/328, 14.1%) had multiple RM ASA contributions. Three hundred and eighty-one total RM with input to the ASA were visualized. Ninety-five RM of the ASA (95/381, 24.9%) were located on the right, 286 (75.1%) on the left. Three hundred and twenty-four RM arteries (85.0%) arose between T8 and L2: 246 (64.5% overall) were located on the left, and 78 (20.5%) on the right. Sixty-one patients (18.2%) had at least one visualized RM contribution to the PSA: 16 patients (16/61, 26.2%) had more than one RM contribution to the PSA. Eighty-seven total RM contributions to the PSA were visualized. Eighty-one (93.1%) RM arose between T6 and L1, 52 of which (59.8% overall) were from the left, and 29 (33.3%) from the right. RM anastomoses with both the ASA and PSA most-commonly originate from the left-sided T6-L2 spinal levels. Multiple RM contributions to the ASA or PSA are less common.