Download PDF
Semin Musculoskelet Radiol 2023; 27(05): 580-587
DOI: 10.1055/s-0043-1772171
Review Article

What the Musculoskeletal Radiologist Needs to Know About the Vascular Anatomy of the Spine and Spinal Cord

Rui Duarte Armindo 
1   Neuroradiology Department, Western Lisbon University Hospital Centre (Centro Hospitalar Universitário Lisboa Ocidental), Lisbon, Portugal
2   Neuroradiology Unit, Hospital da Luz Lisboa, Lisbon, Portugal
,
Pedro Vilela 
1   Neuroradiology Department, Western Lisbon University Hospital Centre (Centro Hospitalar Universitário Lisboa Ocidental), Lisbon, Portugal
2   Neuroradiology Unit, Hospital da Luz Lisboa, Lisbon, Portugal
› Author Affiliations
› Further Information
Also available at
    Permissions and Reprints

Abstract

This article describes the vascular anatomy of the spine and spinal cord, highlighting key structures and anatomical variations relevant to musculoskeletal radiologists. It covers the arterial and venous drainage systems, along with examples of vascular conditions affecting the spine. Understanding the vascular anatomy of the spine and spinal cord is crucial for accurate interpretation of imaging studies and safe spinal interventional procedures. Imaging techniques for evaluating vascular pathology of the spine are discussed and compared. Understanding vascular anatomy and the most common vascular disorders will lead to an accurate diagnosis and suggest the appropriate type of study needed for further characterization and/or patient management.

Keywords

spine - spinal cord - blood supply - angiography


Publication History

Article published online:
10 October 2023

© 2023. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

  • References

  • 1 Krauss WE. Vascular anatomy of the spinal cord. Neurosurg Clin N Am 1999; 10 (01) 9-15
    CrossrefPubMedGoogle Scholar
  • 2 Lasjaunias P, Berenstein A, ter Brugge KG. Clinical Vascular Anatomy and Variations. Berlin, Germany: Springer; 2001
    CrossrefGoogle Scholar
  • 3 Santillan A, Nacarino V, Greenberg E, Riina HA, Gobin YP, Patsalides A. Vascular anatomy of the spinal cord. J Neurointerv Surg 2012; 4 (01) 67-74
    CrossrefPubMedGoogle Scholar
  • 4 Perez Perez VH, Hernesniemi J, Small JE. Anatomy of the great posterior radiculomedullary artery. AJNR Am J Neuroradiol 2019; 40 (12) 2010-2015
    PubMedGoogle Scholar
  • 5 Lazorthes G, Gouaze A, Zadeh JO, Santini JJ, Lazorthes Y, Burdin P. Arterial vascularization of the spinal cord. Recent studies of the anastomotic substitution pathways. J Neurosurg 1971; 35 (03) 253-262
    CrossrefPubMedGoogle Scholar
  • 6 Gruener G, Biller J. Spinal cord anatomy, localization, and overview of spinal cord syndromes. CONTINUUM: Lifelong Learning in Neurology 2008; 14: 11-35
    PubMedGoogle Scholar
  • 7 Miyasaka K, Asano T, Ushikoshi S, Hida K, Koyanagi I. Vascular anatomy of the spinal cord and classification of spinal arteriovenous malformations. Interv Neuroradiol 2000; 6 (Suppl. 01) 195-198
    CrossrefPubMedGoogle Scholar
  • 8 Thron AK. Vascular Anatomy of the Spinal Cord. Cham, Switzerland: Springer; 2016
    CrossrefGoogle Scholar
  • 9 Backes WH, Nijenhuis RJ. Advances in spinal cord MR angiography. AJNR Am J Neuroradiol 2008; 29 (04) 619-631
    CrossrefPubMedGoogle Scholar
  • 10 Islak C, Kocer N. Imaging of vascular disorders of the spine and spinal cord. In: Barkhof F, Jäger H, Thumher M, Rovira A. eds. Clinical Neuroradiology. Cham, Switzerland: Springer; 2019: 2067-2099
    Google Scholar
  • 11 Vilela P. Cranial vessel embryology and imaging anatomy. In: Barkhof F, Jäger H, Thumher M, Rovira A. eds. Clinical Neuroradiology. Cham, Switzerland: Springer; 2019: 95-135
    Google Scholar
  • 12 Bhattacharya JJ, Luo CB, Suh DC, Alvarez H, Rodesch G, Lasjaunias P. Wyburn-Mason or Bonnet-Dechaume-Blanc as cerebrofacial arteriovenous metameric syndromes (CAMS). A new concept and a new classification. Interv Neuroradiol 2001; 7 (01) 5-17
    CrossrefPubMedGoogle Scholar
  • 13 Gregg L, Sorte DE, Gailloud P. Intraforaminal location of thoracolumbar radicular arteries providing an anterior radiculomedullary artery using flat panel catheter angiotomography. AJNR Am J Neuroradiol 2017; 38 (05) 1054-1060
    CrossrefPubMedGoogle Scholar
  • 14 Atsina KB, Cox M, Sedora Roman NI. et al. Vascular imaging of the spine in the US Medicare population: catheter and MR angiography volumes from 2004 to 2016. Neuroradiol J 2020; 33 (04) 318-323
    CrossrefPubMedGoogle Scholar
  • 15 Savader SJ, Williams GM, Trerotola SO. et al. Preoperative spinal artery localization and its relationship to postoperative neurologic complications. Radiology 1993; 189 (01) 165-171
    CrossrefPubMedGoogle Scholar
  • 16 Ozpeynirci Y, Trumm C, Stahl R, Fischer D, Liebig T, Forbrig R. Radiation Dose and fluoroscopy time of diagnostic angiography in patients with spinal dural arteriovenous fistula. Clin Neuroradiol 2022; 32 (03) 791-797
    CrossrefPubMedGoogle Scholar
  • 17 Takase K, Sawamura Y, Igarashi K. et al. Demonstration of the artery of Adamkiewicz at multi- detector row helical CT. Radiology 2002; 223 (01) 39-45
    CrossrefPubMedGoogle Scholar
  • 18 Boll DT, Bulow H, Blackham KA, Aschoff AJ, Schmitz BL. MDCT angiography of the spinal vasculature and the artery of Adamkiewicz. AJR Am J Roentgenol 2006; 187 (04) 1054-1060
    CrossrefPubMedGoogle Scholar
  • 19 Yoshioka K, Niinuma H, Ehara S, Nakajima T, Nakamura M, Kawazoe K. MR angiography and CT angiography of the artery of Adamkiewicz: state of the art. Radiographics 2006; 26 (Suppl. 01) S63-S73
    CrossrefPubMedGoogle Scholar
  • 20 Shin JH, Choi Y, Park B. et al. Diagnostic accuracy and efficiency of combined acquisition of low-dose time-resolved and single-phase high-resolution contrast-enhanced magnetic resonance angiography in a single session for pre-angiographic evaluation of spinal vascular disease. PLoS One 2019; 14 (03) e0214289
    CrossrefPubMedGoogle Scholar
  • 21 Wei XE, Li MH, Qiao RH, Yu WB, Li YH. Feasibility of noninvasive diagnosis of spinal vascular diseases using time-resolved angiography with stochastic trajectories. Front Neurol 2021; 12: 759099
    CrossrefPubMedGoogle Scholar
  • 22 Hoeffner EG, Mukherji SK, Srinivasan A, Quint DJ. Neuroradiology back to the future: spine imaging. AJNR Am J Neuroradiol 2012; 33 (06) 999-1006
    CrossrefPubMedGoogle Scholar
  • 23 Spampinato MV, Nguyen SA, Rumboldt Z. Comparison of gadobenate dimeglumine and gadodiamide in the evaluation of spinal vascular anatomy with MR angiography. AJNR Am J Neuroradiol 2010; 31 (06) 1151-1156
    CrossrefPubMedGoogle Scholar
  • 24 Saindane AM, Boddu SR, Tong FC, Dehkharghani S, Dion JE. Contrast-enhanced time-resolved MRA for pre-angiographic evaluation of suspected spinal dural arterial venous fistulas. J Neurointerv Surg 2015; 7 (02) 135-140
    CrossrefPubMedGoogle Scholar