Journal
NEURORADIOLOGY
Volume 44, Issue 2, Pages 153-157Publisher
SPRINGER-VERLAG
DOI: 10.1007/s002340100658
Keywords
anterior spinal artery; anterior radiculo-medullary artery; artery of Adamkiewicz; spinal cord; spinal cord angiography; spinal cord ischemia; conus medullaris artery
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The main arterial supply of the dorso-lumbar spinal cord is usually derived from a single anterior radiculo-medullary artery called the artery of Adamkiewicz and referred to as having a middle or low location. In some cases, the artery origin is higher, and a vessel which arises in the lower part of the region supplements the supply of the anterior spinal artery. In the literature, those arteries have been described as arising from L3 upwards, and have never been previously described angiographically, to our knowledge, below this level, although Suh and Alexander and Gililan have mentioned this eventuality. Of the 4,000 spinal cord angiographies performed in our institution, we report three cases in which the fourth lumbar artery flows into the anterior spinal artery of the conus medullaris. This anatomical variant may explain the sometimes devastating post-operative neurological complications from a spinal cord infarction on surgery of the lumbar spine or the abdominal aorta below L3.
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