Spinal Vascular Anatomy

• All named vessels are in italics
• Posterior spinal artery (paired) – supplies posterior 1/3, lie medial to dorsal roots; perforators centripetal
• Radicular arteries smaller and more evenly distributed (10-23 vs. 2-17 anterior)
• Anterior spinal artery (paired, join at medulla to form anterior median spinal artery) – supply anterior 2/3; peforators are centrifugal (from anterior median fissure)
• anastemose with anterior radicular arteries (usually 6 cervical, 2-4 thoracic, 1-2 lumbar)
• Distal cord: radicular anastemoses (come through foramen; anterior and posterior radicular arteries) – more prominent on left, join spinal arterial system
• Blood supply by level:
• C1-C4 – anterior/posterior spinal
• C5-C6 – ascending vertebral artery branches, thyrocervical trunk
• C7-T3 – costocervical trunk
• T4-T8 – single radicular artery at T7 – most vulnerable region to low flow
• T9-sacrum – artery of Adamkiewicz (75% between T10-12, usually left T11)
• Lumbar – branches from aorta and iliac arteries
• Sacrum – lateral sacral arteries
• Watershed areas – T1-4, L1, between intermediate and dorsal horns (anterior/posterior perforator watershed)
• Veins
• Anterior median spinal vein
• Posterior coronal veins