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Neurogenic Lower Urinary Tract and Sexual Dysfunction
Published in Karl H. Pang, Nadir I. Osman, James W.F. Catto, Christopher R. Chapple, Basic Urological Sciences, 2021
Karl H. Pang, Nadir I. Osman, Altaf Mangera
Blood supply of the spinal cord:One anterior spinal artery (from vertebral artery)Two posterior spinal arteries (from vertebral artery)Medullary arteriesRadicular arteriesArtery of Adamkiewicz (from anterior segmental medullary artery):Supplies the inferior two-thirds.Originates on the left (75%) side of the aorta between the T8-L1 vertebrae.
The spine
Published in Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie, Bailey & Love's Short Practice of Surgery, 2018
Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie
The blood supply of the spinal cord is derived from the vertebral, deep cervical, intercostal and lumbar arteries. The arteries of the spinal cord include the anterior spinal artery and two posterior spinal arteries, with the anterior spinal artery supplying the majority of the vascular supply to the spinal cord. The radicular artery of Adamkiewicz makes a major contribution to the anterior spinal artery, supplying the lower spinal cord. It originates on the left in 80% of people, usually accompanying the ventral root of T9, T10 or T11, but can originate anywhere from T5 to L5. Ligation of this important artery may lead to critical ischaemia of the spinal cord. Ligating segmental vessels over the midpoint of the vertebral body will minimise the risk of injury to this important artery during anterior approaches to the spine.
The viva: investigation of the neurosurgical patient including neuroradiology and neuropathology
Published in Vivian A. Elwell, Ramez Kirollos, Syed Al-Haddad, Neurosurgery, 2014
Vivian A. Elwell, Ramez Kirollos, Syed Al-Haddad
Ensure an adequate view of the spinal cord and preserve the artery of Adamkiewicz. In 75% of cases, this artery originates on the left side of the aorta between the T8 and L1 vertebral segments.
Preparing the spinal cord – priming or preconditioning? A systematic review of experimental studies
Published in Scandinavian Cardiovascular Journal, 2023
Johanna Herajärvi, Tatu Juvonen
Early studies of the spinal cord anatomy date back to the nineteenth century. The concept of one certain prominent artery, so called artery of Adamkiewicz, built the basis of the understanding of the spinal cord perfusion, and thus the surgical strategy later on for decades [9]. Lazorthes et al. broadened our understanding of the spinal cord blood supply with multiple anastomotic pathways outside the spinal canal within nearby tissues [10]. Thereafter, the concept of collateral network (CN) within the paraspinal muscles that situate alongside spinal canal bilaterally, was introduced by Etz et al. after extensive experimental and clinical analysis over the past decades. The features of the CN include dynamic alterations of the nutrient flow, axial network of small arteries with multiple anastomoses in the spinal canal, in the perivertebral tissue and in the paraspinous muscles. Inputs into the network involve segmental and extrasegmental, subclavian and hypogastric arteries [11–13].
Spinal cord involvement in COVID-19: A review
Published in The Journal of Spinal Cord Medicine, 2023
Ravindra Kumar Garg, Vimal Kumar Paliwal, Ankit Gupta
The spinal cord predominantly receives blood from three main arteries – the anterior spinal artery and two posterior spinal arteries. Reinforcement of blood supply comes from the ascending cervical arteries (branches of the thyrocervical trunk), radicular-medullary branches (branches of the aorta), and the artery of Adamkiewicz (a branch of the aorta) at the level of the lower thoracic or lumbar vertebra. The occlusion of the artery of Adamkiewicz can result in spinal cord ischemia in the thoracolumbar region. Predominantly, this infarction is caused by aortic disease, thoracolumbar surgery, sepsis, hypotension, and thromboembolic disorders. Therefore, we suggest that spinal cord infarction because of hypercoagulability can lead to myelopathy in patients with COVID-19.46,47
Giant spinal nerve sheath tumours – Surgical challenges: case series and literature review
Published in British Journal of Neurosurgery, 2019
Ming-Te Lee, Sasan Panbehchi, Priyank Sinha, Jagan Rao, Neil Chiverton, Marcel Ivanov
We recommend that all patients with GNST should undergo vascular imaging and CT scan of the affected spinal segments. The importance of these is illustrated in case 1 and case 4 of our series. Specialist imaging of the vasculature in the vicinity of the tumour is crucial and should be studied in detail as part of the pre-operative surgical planning. It may ultimately determine the optimal surgical approach in each individual patient. With hindsight, we reflected on the fact that in case 1, we had not fully appreciated the relationship between the tumour and the SVC. In our case, SVC syndrome was promptly recognised and addressed, but it highlighted the significant role of careful surgical planning. Pre-operatively CT scanning of the spine is invaluable to assess stability of the spine pre-operatively guiding the decision whether fusion may be needed or not. In case 4, CT spine showed involvement of more than 1 column of the spine, which is biomechanically unstable and hence mandated an instrumented fusion. In GNST involving lower thoracic spine, spinal angiography may also have a role to identify the artery of Adamkiewicz.