Microsurgical anatomy of the artery of Adamkiewicz and its segmental artery

Abstract

<jats:sec> <jats:title>Object</jats:title> <jats:p>The blood supply of the lower spinal cord is heavily dependent on the artery of Adamkiewicz, which characteristically originates from one of the thoracolumbar segmental arteries. The aforementioned artery is of enormous clinical, surgical, and radiological importance, and the goal of this study was to elucidate the course and branches of the segmental artery that gives rise to this important vessel.</jats:p></jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>In this cadaveric, microsurgical anatomical study, the authors investigate and describe the course and branches of the artery of Adamkiewicz and the segmental branch from which it ultimately originates. A review of the literature is provided.</jats:p></jats:sec> <jats:sec> <jats:title>Conclusions</jats:title> <jats:p>By documenting the microsurgical anatomy of these important vessels, this study facilitates an understanding of the anatomy that will aid in treatment planning for surgery of various lesions in this area.</jats:p></jats:sec>

Extraforaminal needle tip position reduces risk of intravascular injection in CT-fluoroscopic lumbar transforaminal epidural steroid injections

“…The specific neural foraminal level and laterality of the artery of Adamkiewicz is highly variable: it most often originates between the T9 and L3 levels and usually on the left, but origins from as high as the T2 level and as low as the S2 level have been described (17)(18)(19)(20)(21)(22). In practice, the proceduralist must assume that the artery of Adamkiewicz could be present in any thoracic, lumbar, or upper sacral neural foramen.…”

Detection of the Adamkiewicz artery in computed tomography of the thorax and abdomen

“…The ASA varies in size from approximately 0.5 to 0.8 mm in the thoracolumbar region. 4 Its greatest diameter is at the level of its conjunction with AKA, and usually measures 0.5-0.8 mm, but may be as large as 1.0 mm. 4 In the thoracolumbar region, the course of the ASA varies from straight (Fig.…”

“…1, 2). [3][4][5] Preoperative anatomical evaluation of the AKA is essential in many clinical disciplines: vascular surgery (aortic aneurysms), neurosurgery (intramedullary tumors), as well as urology and pediatric surgery (retroperitoneal dissections), because it helps avoid serious neurological complications such as paraplegia or paraparesis. 1,2 The aim of this study was to evaluate the detection of the AKA, as well as its level and the side of origin, with multi-detector contrast enhanced computed tomography (MDCT) of the abdomen and thorax performed during everyday clinical practice, and to compare the results with the literature.…”

Albert Wojciech Adamkiewicz (1850–1921): unsung hero behind the eponymic artery

“…18 Lazorthes et al 18 have noted a T9-12 origin in 74% of cases, between T5 and T8 in 15%, and from L1 to L2 in 10%. Alleyne et al 1 have reported a leftsided origin in 78% of cases and an origin branching from T9 to T12 in 60% of cases, from L1 in 25%, and from T5 to T8 in 15%. The leftsided predominance was most prob ably due to an aorta located on the left side.…”