Blood Supply of Cervical Spinal Cord in Man

A Microangiographic Cadaver Study

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Adamkiewicz1,2 and Kadyi17 described the blood supply of the spinal cord in the 19th century. Kadyi's monograph is detailed, highly accurate, and illustrated with full-paged colored plates. His studies have been repeated many times both to confirm them and to bring the knowledge into the English and French languages.5,8,10,12,14,16,18,20,21 All investigators have relied upon conventional techniques with the result that Kadyi's few mistakes have escaped detection. Those who used radiography10,18 did not employ methods refined enough to demonstrate small vessels clearly.

Article Information

Address: Department of Surgery, Vancouver General Hospital, Vancouver 9, British Columbia, Canada.

© AANS, except where prohibited by US copyright law.

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Figures

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    Transverse sections showing relationship of vertebral arteries (arrows) to roots at 4th cervical level. ×3.

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    Posterior radicular artery (arrow) accompanying an 8th cervical posterior root. The rootlets are held apart with a pin to demonstrate the artery which runs on the anterior surface of the root.

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    Two photographs of anterior radicular arteries reaching the anterior spinal artery. A. The anterior spinal artery is solitary and 2 anterior radicular arteries are seen joining it, a large one on a C8 root and a small one on a C7 root on the opposite side. B. The anterior spinal artery is paired for much of its course. It is joined by 3 anterior radicular arteries, a large one on a C6 root and 2 small ones on C5 and C7 roots on the opposite side. Arteries are filled with white contrast material; veins contain blood and are dark.

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    Transverse section at 4th cervical level showing tortuous, looped arteries in the roots and on the surface of the cord in a 79-year-old woman. ×4. Enlarged detail in inset.

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    Microradiogram of section 2 mm. thick cut in mid-coronal plane. In this plane, the central arteries pass to either side and the overlapping of their terminal branches can be seen. Arteries of pial plexus supply the outer portion of the cord. Tortuous small arteries can be seen. × 5.

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    A branch from a central artery supplies the basal part of the posterior columns and others reach out into the lateral columns. Tortuous small arteries visible. Sixth cervical segmental level. Transverse section 2 mm. thick. × 9.

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    Postero-anterior (A) and lateral (B) microangiograms of the same specimen (no. 16) at the same level (C6–7) and magnification ×8. The 3 pairs of central arteries in the lower half of the P-A projection can be seen in the lateral projection to arise from the anterior spinal artery on short common stalks. × 6.

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    Photograph of a dissection of one of the pairs of central arteries seen in Fig. 5. cs, common stem; p, pia of anterior median fissure; tb, terminal branches. Lateral view with spinal cord tissue removed. × 14.

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    Postero-anterior microangiogram at level of 7th cervical segment. In the diagram on the right, the anterior spinal and anterior radicular artery are indicated with shading, the posterior spinal arteries have interrupted outlines and the central arteries are drawn with solid lines. The small vessels not shown in the diagram are mostly in the pia. The marker in the diagram indicates 1 cm. × 5.

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    Diagram of distribution of central and peripheral arterial systems. The white areas are supplied by only one system; the shaded area by both.

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    Arteries from the pial plexus pass through the lateral cortico-spinal tracts to reach the edge of the grey matter. Fourth cervical segmental level. Transverse section 3 mm. thick. × 9.

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    Dense capillary beds in grey matter define its outline. Veins originate from central parts of gray matter while capillaries are most dense about its periphery. Fourth cervical segmental level. Transverse section 4 mm. thick. × 9.

References

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