Spinal Arteries Venous Plexus

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Spinal Arteries

Venous Plexus

A single
anterior spinal artery and two posterior spinal arteries, originating intracranially from the
vertebral arteries, run longitudinally along the length of the cord and are joined segmentally in
each region by segmental arteries (Fig. 2-20). The largest of these segmental branches is the
major segmental artery (of Adamkiewicz), found in the lower thoracic or upper lumbar region;
it is the major blood supply for the lower two thirds of the spinal cord. The dorsal and ventral
roots are supplied by segmental radicular (medullary) arteries.

Multiple anterior and posterior spinal veins run the length of the cord and drain into segmental
(medullary) radicular veins (see Fig. 2-9). Radicular veins receive tributaries from the internal
vertebral veins that course within the vertebral canal. Radicular veins then drain into segmental
veins, with the blood ultimately collecting in the following locations
After entering an intervertebral foramen, the segmental spinal arteries give rise to anterior and
posterior radicular arteries (Fig. 2.49). This occurs at every vertebral level. The radicular
arteries follow, and supply, the anterior and posterior roots. At various vertebral levels, the
segmental spinal arteries also give off segmental medullary arteries (Fig. 2.49). These
vessels pass directly to the longitudinally oriented vessels, reinforcing these.

The longitudinal vessels consist of:

1. ▪

a single anterior spinal artery, which originates within the cranial cavity as the union of
two vessels that arise from the vertebral arteries—the resulting single anterior spinal
artery passes inferiorly, approximately parallel to the anterior median fissure, along the
surface of the spinal cord; and

2. ▪

two posterior spinal arteries, which also originate in the cranial cavity, usually arising
directly from a terminal branch of each vertebral artery (the posterior inferior cerebellar
artery)—the right and left posterior spinal arteries descend along the spinal cord, each as
two branches that bracket the posterolateral sulcus and the connection of posterior roots
with the spinal cord.

The anterior and posterior spinal arteries are reinforced along their length by eight to ten
segmental medullary arteries (Fig. 2.49). The largest of these is the arteria radicularis magna
or the artery of Adamkiewicz (Fig. 2.49). This vessel arises in the lower thoracic or upper
lumbar region, usually on the left side, and reinforces the arterial supply to the lower portion of
the spinal cord, including the lumbar enlargement.

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