Spinal cord arterial supply
Anterior spinal artery
- Originates from small branches of the vertebral arteries that fuse into a single trunk at the level of foramen magnum.
- Descends along the anterior median fissure and receives several tributaries along its course that pass through the intervertebral foramina.
- The most important tributary is the artery of Adamkiewicz which typically arises at the level of the 9th to 12th intercostal artery on the left.
- Other arteries supplying tributaries include:
- Vertebral
- Ascending cervical
- Inferior thyroid
- Lumbar
- Iliolumbar
- Lateral sacral
Posterior spinal arteries
- Arise from the PICA (75%) or vertebral arteries (25%).
- Descend posterolaterally along the entire spinal cord and receive multiple segmental and radicular tributaries that enter the spinal canal through the intervertebral foramina.
- The paired posterior spinal arteries anastomose at multiple levels and also form anastomoses with the anterior spinal artery through a spinal pial plexus.