Blood Supply of the Spinal Cord

Arterial Supply of the Spinal Cord

The arterial supply of the spinal cord by the vertebral arteries. It is also from the branches ultimately from the thoracic and abdominal aorta, called the radicular arteries. Each vertebral artery (or posterior inferior cerebral artery) gives rise to a posterior spinal artery, which proceeds along the line of attachment of the dorsal roots.

Arterial Supply of the Spinal Cord

Each vertebral artery also gives rise to an anterior spinal artery. The 2 anterior spinal arteries fuse to form a single midline vessel. This courses along the anterior median fissure of the spinal cord.

Arterial Supply of the Spinal Cord

The posterior spinal arteries and the anterior spinal artery supply upper cervical levels with from the vertebral arteries. Below this, all 3 spinal arteries form a more or less continuous series of anastomoses with radicular arteries.

Arterial Supply of the Spinal Cord

Beginning with lower cervical segments, the spinal cord depends on the radicular arteries for its survival. The great radicular artery (of Adamkiewicz), present at the spinal cord level T12-L2 may provide the entire arterial supply for the caudal 2/3 of the spinal cord.

Arterial Supply of the Spinal Cord

The very long anterior spinal artery is usually a continuous vessel for the length of the spinal cord.

Arterial Supply of the Spinal Cord

It gives rise to hundreds of central and circumferential branches. These supply the anterior 2/3 of the spinal cord. This includes the base of the posterior horn and a variable portion of the lateral corticospinal tract.

Arterial Supply of the Spinal Cord

The posterior spinal arteries are really more of a plexiform network of small arteries. They supply the posterior columns, substantia gelatinosa, dorsal root entry zone, and a variable portion of the lateral corticospinal tract.

Anterior Cord Syndrome

Anterior cord syndrome is very rare and involves the anterior two thirds of the spinal cord, leaving only the posterior columns intact. It most commonly follows a vascular insult such as a great vessel injury, vertebral body fracture, or anterior spinal canal occlusive tumors.

Anterior Cord Syndrome

Pa=ents usually present with an acute loss of motor and most sensory func=on below the level of the injury. Bowel and bladder func=on is usually aected because of a loss of sensory input.

Anterior Cord Syndrome

Sparing of the posterior columns preserves some deep pressure, vibratory, and light touch sensa=on. The prognosis for recovery in this syndrome is very limited4.

Posterior Cord Syndrome

Aects the posterior column, dorsal roots, & part of lateral cor=cospinal tract Dorsal roots
Loss of all sensory innerva=on at the involved segment

Posterior column
Vibra=on, Propriocep=on, stereognosis, 2-point discrimina=on, and ne touch loss on both sides below the involved segment

Part of cor=cospinal tract

Varying degrees of muscle weakness