Anterior Spinal Arteries
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In
human anatomy Human anatomy (gr. ἀνατομία, "dissection", from ἀνά, "up", and τέμνειν, "cut") is primarily the scientific study of the morphology of the human body. Anatomy is subdivided into gross anatomy and microscopic anatomy. Gross ...
, the anterior spinal artery is the
artery An artery () is a blood vessel in humans and most other animals that takes oxygenated blood away from the heart in the systemic circulation to one or more parts of the body. Exceptions that carry deoxygenated blood are the pulmonary arteries in ...
that supplies the anterior portion of the
spinal cord The spinal cord is a long, thin, tubular structure made up of nervous tissue that extends from the medulla oblongata in the lower brainstem to the lumbar region of the vertebral column (backbone) of vertebrate animals. The center of the spinal c ...
. It arises from branches of the
vertebral arteries The vertebral arteries are major arteries of the neck. Typically, the vertebral arteries originate from the subclavian arteries. Each vessel courses superiorly along each side of the neck, merging within the skull to form the single, midline ...
and courses along the anterior aspect of the spinal cord. It is reinforced by several contributory arteries, especially the artery of Adamkiewicz.


Anatomy


Origin

The anterior spinal artery arises bilaterally as two small branches near the termination of the
vertebral arteries The vertebral arteries are major arteries of the neck. Typically, the vertebral arteries originate from the subclavian arteries. Each vessel courses superiorly along each side of the neck, merging within the skull to form the single, midline ...
. One of these vessels is usually larger than the other, but occasionally they are about equal in size.


Course

Descending in front of the
medulla oblongata The medulla oblongata or simply medulla is a long stem-like structure which makes up the lower part of the brainstem. It is anterior and partially inferior to the cerebellum. It is a cone-shaped neuronal mass responsible for autonomic (involun ...
, they unite at the level of the
foramen magnum The foramen magnum () is a large, oval-shaped opening in the occipital bone of the skull. It is one of the several oval or circular openings (foramina) in the base of the skull. The spinal cord, an extension of the medulla oblongata, passes thro ...
. The single trunk descends in the front of the medulla spinalis, extending to the lowest part of the medulla spinalis. It is continued as a slender twig on the
filum terminale The filum terminale ('terminal thread') is a delicate strand of fibrous tissue, about 20 cm in length, extending inferiorly from the apex of the conus medullaris to attach onto the coccyx. The filum terminale acts to anchor the spinal cord ...
. The vessel passes in the
pia mater Pia mater ( or ),Entry "pia mater"
in
anterior median fissure.


Branches

On its course the artery takes several small branches (i.e. anterior segmental medullary arteries), which enter the
vertebral canal In human anatomy, the spinal canal, vertebral canal or spinal cavity is an elongated body cavity enclosed within the dorsal bony arches of the vertebral column, which contains the spinal cord, spinal roots and dorsal root ganglia. It is a proc ...
through the
intervertebral foramina The intervertebral foramen (also neural foramen) (often abbreviated as IV foramen or IVF) is an opening between (the intervertebral notches of) two pedicles (one above and one below) of adjacent vertebra in the articulated spine. Each interve ...
. These branches are derived from the
vertebral artery The vertebral arteries are major artery, arteries of the neck. Typically, the vertebral arteries originate from the subclavian arteries. Each vessel courses superiorly along each side of the neck, merging within the skull to form the single, m ...
, the ascending cervical artery, a branch of the
inferior thyroid artery The inferior thyroid artery is an artery in the neck. It arises from the thyrocervical trunk and passes upward, in front of the vertebral artery and longus colli muscle. It then turns medially behind the carotid sheath and its contents, and a ...
in the neck, the
intercostal arteries The intercostal arteries are a group of arteries passing within an intercostal space (the space between two adjacent ribs). There are 9 anterior and 11 posterior intercostal arteries on each side of the body. The anterior intercostal arteries a ...
in the
thorax The thorax (: thoraces or thoraxes) or chest is a part of the anatomy of mammals and other tetrapod animals located between the neck and the abdomen. In insects, crustaceans, and the extinct trilobites, the thorax is one of the three main di ...
, and from the lumbar artery,
iliolumbar artery The iliolumbar artery is the first branch of the posterior trunk of the internal iliac artery. Structure The iliolumbar artery is the first branch of the posterior trunk of the internal iliac artery. It turns upward behind the obturator nerve and ...
and lateral sacral arteries in the
abdomen The abdomen (colloquially called the gut, belly, tummy, midriff, tucky, or stomach) is the front part of the torso between the thorax (chest) and pelvis in humans and in other vertebrates. The area occupied by the abdomen is called the abdominal ...
and
pelvis The pelvis (: pelves or pelvises) is the lower part of an Anatomy, anatomical Trunk (anatomy), trunk, between the human abdomen, abdomen and the thighs (sometimes also called pelvic region), together with its embedded skeleton (sometimes also c ...
.


Distribution

It supplies the pia mater, and the substance of the medulla spinalis, also sending off branches at its lower part to be distributed to the
cauda equina The cauda equina () is a bundle of spinal nerves and spinal nerve rootlets, consisting of the second through fifth lumbar nerve pairs, the first through fifth sacral nerve pairs, and the coccygeal nerve, all of which arise from the lumbar enl ...
.


Disorders

Disruption of the anterior spinal artery leads to bilateral disruption of the
corticospinal tract The corticospinal tract is a white matter motor pathway starting at the cerebral cortex that terminates on lower motor neurons and interneurons in the spinal cord, controlling movements of the limbs and trunk. There are more than one million neu ...
, causing motor deficits, and bilateral disruption of the
spinothalamic tract The spinothalamic tract is a nerve tract in the anterolateral system in the spinal cord. This tract is an ascending sensory pathway to the thalamus. From the ventral posterolateral nucleus in the thalamus, sensory information is relayed upwar ...
, causing sensory deficits in the form of pain/temperature sense loss. It is called anterior spinal artery syndrome. This occurs when the disruption of the anterior spinal artery is at the level of the spinal cord. Contrast this with medial medullary syndrome, when the anterior spinal artery is occluded at the level of the
medulla oblongata The medulla oblongata or simply medulla is a long stem-like structure which makes up the lower part of the brainstem. It is anterior and partially inferior to the cerebellum. It is a cone-shaped neuronal mass responsible for autonomic (involun ...
. Disruption of its perforating branches (sulcal artery) can result in a hemicord syndrome. In fact, acute sulcal artery syndrome should be suspected in patients with acute hemicord syndrome, and vertebral artery dissection should be suspected in cases of high cervical cord involvement. In a recent review by Tan YJ, et al. in 2021, good functional recovery was seen in most, and vertebral artery dissection was the leading cause of sulcal artery syndrome.


Additional images

Image:Arteries_beneath_brain.png, The arteries of the base of the brain. Image:Circle of Willis en.svg , Arteries of the
brain The brain is an organ (biology), organ that serves as the center of the nervous system in all vertebrate and most invertebrate animals. It consists of nervous tissue and is typically located in the head (cephalization), usually near organs for ...
,
brain stem The brainstem (or brain stem) is the posterior stalk-like part of the brain that connects the cerebrum with the spinal cord. In the human brain the brainstem is composed of the midbrain, the pons, and the medulla oblongata. The midbrain is co ...
and upper
spinal cord The spinal cord is a long, thin, tubular structure made up of nervous tissue that extends from the medulla oblongata in the lower brainstem to the lumbar region of the vertebral column (backbone) of vertebrate animals. The center of the spinal c ...
(inferior view).


References


External links


Spinal Arterial Anatomy at Neuroangio.org
*Yoshioka K, Niinuma H, Ohira A, Nasu K, Kawakami T, Sasaki M, Kawazoe K. MR angiography and CT angiography of the artery of Adamkiewicz: noninvasive preoperative assessment of thoracoabdominal aortic aneurysm. Radiographics. 2003 Sep-Oct;23(5):1215-25.
Full Text
*Tan YJ, Ng GJ, Lai J. Sulcal artery syndrome: A Three-patient series and review of literature. J Clin Neurosci. 2021 Jun;88:45-51.
Drawing of the anterior spinal arteryHorizontal view of blood supply to the spinal cord
{{Authority control Arteries of the head and neck