Journal of Neurosurgical Sciences 2020 Nov 30

DOI: 10.23736/S0390-5616.20.05201-7

Copyright © 2020 EDIZIONI MINERVA MEDICA

lingua: Inglese

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

Anthony S. LARSON ¹ ✉, Waleed BRINJIKJI ^{1, 2}

¹ Mayo Clinic Department of Radiology, Rochester, MN, USA; ² Mayo Clinic Department of Neurosurgery, Rochester, MN, USA

BACKGROUND: Anterior and posterior spinal arteries (ASA, PSA) receive vital collateral flow from radiculomedullary arteries (RM). The purpose of this study was to review a series of spinal angiograms in order to characterize normal RM arterial anatomy.
METHODS: 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.
RESULTS: 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. 46 patients (46/328 = 14.1%) had multiple RM ASA contributions. 381 total RM with input to the ASA were visualized. 95 RM of the ASA (95/381 = 24.9%) were located on the right, 286 (75.1%) on the left. 324 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. 61 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. 87 total RM contributions to the PSA were visualized. 81 (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.
CONCLUSIONS: Radiculomedullary 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.

KEY WORDS: Spinal angiography; Spinal cord; Adamkiewicz