Blood supply to the human spinal cord: Part I. Anatomy and hemodynamics

Abstract

The arterial network that supplies the human spinal cord, which was once thought to be similar to that of the brain, is in fact much different and more extensive. In this article, the authors attempt to provide a comprehensive review of the literature regarding the anatomy and known hemodynamics of the blood supply to the human spinal cord. Additionally, as the medical literature often fails to provide accurate terminology for the arteries that supply the cord, the authors attempt to categorize and clarify this nomenclature. A complete understanding of the morphology of the arterial blood supply to the human spinal cord is important to anatomists and clinicians alike.

The early history of our understanding of the functions of the spinal cord

“…Through clinical correlations between both symptoms and lesions of the spine, along with early manipulative investigations, historical researchers were able to identify the spinal cord as an important conduit for signals to and from the brain. Contemporary researchers [2,[11][12][13][14][15][16][17] have used investigative techniques that have gone beyond surgical manipulation and stimulation to visualize the various components of the central Fig. 1 and cover figure Collage demonstrating physicians who have studied the spinal cord over human history.…”

Anterior Cord Syndrome after Embolization for Malignant Hemoptysis

“…Rather than being a single, continuous vessel, the ASA is made of multiple anastomotic networks but can be discontinuous. 4 The implication is that if a large radiculomedullary vessel is occluded, adequate collateral flow from the more cranial portions of the ASA cannot be counted on to supply sufficient blood flow. 4 When a segmental vessel is occluded, the greatest damage is located at the level of entrance of the medullary artery, but changes are seen both above and below the cord.…”

Variable anatomic configuration of the posterior spinal arteries in humans

“…During their descending course they join a variable number of posterior radiculomedullary arteries to form the posterior anastomotic pathway. At the level of the conus medullaris, this pathway joins the anterior spinal artery (ASA) to constitute the cruciate anastomosis of the conus medullaris (Bolton, ; Gillilan, ; Tveten, ; Bosmia et al, ; Griessenauer et al, ; Martirosyan et al, ; Van Schoor et al, ; Tubbs et al, ; Arya and Weissbart, ; Rojas et al, ).…”