Blood Supply of the Spinal Cord

Spinal cord II | Main Anatomy Index | The brainstem

• 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.

• 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.

• 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.

• 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.

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

• 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.

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• This is by 6 irregular, plexiform channels.
• There is one along:

1. The anterior and posterior midlines;
2. Along the line of attachment of the dorsal roots of each side;
3. Along the line of attachment of the ventral roots of each side.

• These are drained by the radicular veins.
• Each, in turn empty into the epidural venous plexus.

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