Arteries of spinal cord

The arteries of the spinal cord are the vessels responsible for supplying arterial blood to the spinal cord and its associated structures. The spinal cord receives its blood supply from three main longitudinal arteries: one anterior spinal artery and two posterior spinal arteries. These longitudinal arteries are supplemented by segmental arteries, which give rise to radiculomedullary and radicular branches that enter the spinal canal alongside the nerve roots.

The anterior spinal artery is a single midline vessel formed by the union of branches from the vertebral arteries at the craniovertebral junction. It descends along the anterior median fissure and supplies the anterior two-thirds of the spinal cord. Its continuity and perfusion are reinforced at various levels by anterior radiculomedullary arteries, the most prominent of which is the artery of Adamkiewicz, typically arising between T9 and L2, and is critical for the thoracolumbar cord.

The posterior spinal arteries are paired vessels that originate from either the vertebral arteries or the posterior inferior cerebellar arteries. They run longitudinally along the posterolateral aspect of the cord and supply the posterior one-third. Their origins and course can be variable, and they are supplemented by posterior radiculomedullary arteries at multiple levels.

These longitudinal arteries are interconnected by a pial arterial plexus, and the segmental arteries (arising from vertebral, intercostal, and lumbar arteries) provide additional collateral supply via radiculomedullary branches. The number and distribution of these segmental feeders are variable, but only a few are dominant in perfusing the cord, especially in the thoracolumbar region.