Artery of Adamkiewicz (great anterior radiculomedullary artery)
Sub-branch · T8–L1 (peak T9–T11) Left ~75%
The dominant feeder of the anterior spinal artery for the lower two-thirds of the cord. Arises from a left posterior intercostal or upper lumbar artery in about three-quarters of people, most often between T9 and T12 (range T8–L1), enters the canal with a nerve root and makes a hairpin turn onto the anterior spinal artery.
Traced from the start
- Descending thoracic aorta
- Posterior intercostal arteries (3rd–11th)
- Artery of Adamkiewicz (great anterior radiculomedullary artery)
Detail
- Origin
- Left posterior intercostal or lumbar artery, T8–L1 (peak T9–T11), left-sided in about 75%
- Supplies
- Anterior spinal artery from about T8 down to the conus
- Watershed
- Mid-thoracic cord (T4–T8) sits between the cervical feeders and the Adamkiewicz supply
When it goes wrong
Open or endovascular repair of a thoracoabdominal aneurysm, aortic cross-clamping, or a type B dissection occluding the intercostal ostia
Anterior spinal artery syndrome: paraplegia (flaccid then spastic) with loss of pain and temperature below the lesion and sphincter loss, but preserved vibration and proprioception because the dorsal columns are fed by the posterior spinal arteries
Profound hypotension (cardiac arrest, ruptured AAA)
Watershed infarction of the mid-thoracic cord with the same anterior cord picture
Practise this structure
1 question in the bank tagged Arterial Supply.