title: The vascular supply to the spinal cord and its relationship to anterior spine surgical approaches.
abstract: BACKGROUND
  The understanding of vascular supply to the spinal cord is important given that the evolution of surgical approaches to the spine may bring along the potential for more frequent complications, especially a rare but devastating complication: that of spinal cord ischemia or infarction. To maximally avoid this complication, the relationship between the spinal cord vascularity and the anterior spine surgical approach needs further study.
  
  
  OBJECTIVE
  To provide a theoretical basis that will allow the spinal surgeon to take appropriate steps to avoid spinal cord ischemia during anterior spinal surgery through anatomic means.
  
  
  METHODS
  Spinal cord vascular casting assessment with cadaveric specimen.
  
  
  METHODS
  Twenty adult cadaveric specimens (11 men and 9 women) were obtained for the latex perfusion and vessel dissection. In addition, nine patients (seven men and two women) underwent superselective angiography of the spinal cord. The segmental arterial anastomosis and radiculomedullary vessels in the thoracolumbar region were shown and reviewed.
  
  
  RESULTS
  There were approximately 21 pairs of segmental arteries in the thoracolumbar region. Adjacent segmental arteries were networked with each other. The latex infusion specimens demonstrated 72 anterior radiculomedullary arteries and 177 posterior radiculomedullary arteries in all 20 samples. The anterior and posterior spinal arteries were also networked with each other at several levels. Superselective spinal angiography was consistent with the latex infusion specimens showing.
  
  
  CONCLUSIONS
  The variety of anatomy of spinal cord arterial networks is shown, and the relation between the blood supply of certain spinal levels and the potential ischemic complications during the anterior surgical approach is discussed. It is hopefully of benefit to surgeons, after fully understanding the anatomy of these spinal vascular supply structures, that there may be even greater avoidance of vascular compromise in these challenging operations.
authors.affiliation: Institute of Orthopaedics and Traumatology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, 107 Yanjiangxi Rd, Guangdong 510120, People's Republic of China.
authors.forename: Liangbin
authors.initials: L
authors.lastname: Gao
authors.forename: Le
authors.initials: L
authors.lastname: Wang
authors.forename: Bin
authors.initials: B
authors.lastname: Su
authors.forename: Peng
authors.initials: P
authors.lastname: Wang
authors.forename: Jichao
authors.initials: J
authors.lastname: Ye
authors.forename: Huiyong
authors.initials: H
authors.lastname: Shen
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000379:methods*; D013116:Spinal Cord / Q000098:blood supply*; D013131:Spine / Q000601:surgery*
keywords: Spinal anatomy; Spinal cord; Surgical approach; Vascular supply