ANATOMY OF THE SPINAL CORD’S BLOOD SUPPLY. Review
Article PDF

Keywords

spinal cord vascularization, cervical region, radiculo-medullary arteries

Abstract views: 3942
PDF Downloads: 178

How to Cite

Chernyak , V., Shevchenko, O., Zorenko, O., Levon, M., Selivanov , S., & Holinko V.M., V. (2020). ANATOMY OF THE SPINAL CORD’S BLOOD SUPPLY. Review. Medical Science of Ukraine (MSU), 16(2), 59-68. https://doi.org/10.32345/2664-4738.2.2020.11

Abstract

Relevance. The traditional scheme of blood supply to the spinal cord, formed in the 60-70s of the last century, does not correspond to the pathogenesis of many neurological disorders of the spinal cord. There is also a discrepancy in terminology: the names of arteries found in surgical and neurological works do not correspond to the names of the International Anatomical Nomenclature. Therefore, today this issue needs further analysis.

Objective: to summarize the information of different authors on the number of spinal branches and their branches, topography, blood supply to each segment of the spinal cord, to analyze the individual variability of sources of blood supply to the spinal cord.

Materials and methods. Analysis of scientific publications in the international electronic scientometric database PubMed by keywords for the period 2000-2018. and comparing these data with the imaginations of 1760-1993.

Results. The idea of ​​the structural organization of the blood supply to the spinal cord has changed. With modern data, intracranial sources, namely: anterior and posterior spinal arteries, the blood supply to the true cervical spinal cord, and the rest of the department - lower cervical, thoracic, lumbar, sacral and coccygeal - blood supply from extracranial sources, and they exist in this area segmental branches of the aorta. Nowadays, extracranial sources are considered the main in the blood supply to the spinal cord. It is now known that the anterior and posterior spinal arteries are intermittent and cannot provide blood supply to the spinal cord, as previously thought. The general plan of arterial blood supply of a spinal cord can be presented in the form of a set of pools of front and back radical (radiculomedullary) arteries. The anterior radicular arteries are 4-8, and the posterior 15-20, respectively, along the spinal cord in its ventral and dorsal departments the same number of arterial pools are formed. There are anastomotic connections between these pools, which are not always functionally complete. Each of these basins is supplied by a separate radiculomedullary artery. Each such artery feeds not one but several segments of the spinal cord. The number and levels of approach to the spinal cord of radiculomedullary arteries, especially the anterior ones, differ significantly in individual variability. The perception of the vascularization of the cervical spinal cord was analyzed. At different times, information about the number of arteries that supplied blood to this department differed significantly: in 1760 it was believed that it was 31 arteries; and in 1882-1939 - only 7; in 1943 - 27, in 1958 - 6-8; in 1958 - 7-10; in 1961-1963 - 5-8; in 1966-1973 - 5; in 1993 - 1-2 arteries. Such different information about spinal cord vascularization is the result of significant individual variability.

Conclusions. Incomplete current knowledge about the blood supply to the spinal cord is the cause of unresolved problems of etiology, pathogenesis, and clinical course of spinal ischemic strokes, including cervical localization. The existing terminological confusion regarding the names of the arteries that supply blood to the spinal cord, in particular its cervical region, is explained by the significant variability of the radiculomedullary arteries of this zone in terms of number, diameter, and location. Due to the existence of arterio-venous anastomoses, arterial myelobulbar anastomoses, adjacent areas of blood supply in this area, theft phenomena are formed and distant foci of ischemia appear, including both the spinal cord and the brain. Therefore, in order to make an angiotopic diagnosis, it is necessary to take into account not only anatomical but also physiological and pathophysiological aspects of regulation and compensation of cerebral circulation.

https://doi.org/10.32345/2664-4738.2.2020.11
Article PDF

References

[Human anatomical atlas: translation from the 8th English edition. - 3rd edition / F. Martini. – K.: Medicine, 2018: 128 p. [in Ukrainian]. URL: https://znannia.com.ua/product/anatomichnii_atlas_lyudini_pereklad_z_8go_angliis4kogo_vidannya_angliis4koyu_ukrains4koyu_rosiis4koyu_ta_latins4koyu_movami_frederik_martini

Badalyan L.O. [Neuropathology. Textbook]. – M.: Academy, 2007: 400 p. [in Russian]. URL: https://gist.github.com/anonymous/3b87d7333a618a83f64a0bfbd2313a10

Vilensky BS. [Emergencies in neurology: A guide for physicians]. – S.-Pb.: FOLIANT, 2004: 512 p. [in Russian].

Guzeva VI. [Handbook of Pediatric Neurology]. – M.: MIA, 2009: 640 p. [in Russian]. URL: https://www.booksmed.com/nevrologiya/2625-rukovodstvo-po-detskoy-nevrologii-guzeva.html

[Pediatric neurology. Textbook in 2 vol. / ed. O.S Petrukhin]. – M.: GEOTAR-Media, 2018: 272 p. [in Russian]. URL: http://www.geotar.ru/lots/NF0009635.html

Zhulev NM, Badzgaradze Yu. D., Zhulev SN. [Osteochondrosis of the spine. Manual for physicians]. – S.-Pb.: Lany, 1999: 592 p. [in Russian]. URL: https://www.booksmed.com/nevrologiya/2827-osteohondroz-pozvonochnika-zhulev.html

Lutsik AA, Kazantsev VV, Bondarenko G.Yu., Peganov AI. [Vascular myelopathy, caused by compression or stenosis abnormal vertebral artery, supplying the thickening of the cervical spinal cord] // Medicine in Kuzbass. 2014;13 (2): 55-62 [in Russian]. URL: http://mednauki.ru/index.php/MK/issue/viewIssue/114/114

[International anatomical nomenclature: Ukrainian standard: Textbook] / ed. II Bobryk, VG Koveshnikov. – K.: Zdorov`ya, 2001: 327 p. [in Ukrainian]. URL: http://library.univer.kharkov.ua/OpacUnicode/index.php?url=/notices/index/IdNotice:261458/Source:default#

[Nervous diseases: a textbook for medical students] / ed. MM Odinaka. – S.-Pb.: SpetsLit, 2014: 526 p. [in Russian]. URL: https://speclit.su/image/catalog/978-5-299-00587-5/978-5-299-00587-5.pdf

Netter F. [Atlas of human anatomy] / Ed. N.O. Bartosh, L.L. Kolesnikov. – M.: GEOTAR-Media, 2007: 624 p. [in Russian]. URL: http://www.medlan.samara.ru:8006/images/1-349.jpg

Olson T. R. [Atlas of human anatomy. A.D.A.M.] – M.: Med. lit., 2012.2012: 504 p. [in Russian]. URL: https://kim.by/catalog/anatomiya-i-fiziologiya/atlas-anatomii-cheloveka.-a.d.a.m.

Popelyansky Ya. Yu. Orthopedic neurology (vertebroneurology). A guide for doctors. – M: MEDpress-inform, 2011: 672 p. [in Russian]. URL: https://www.mmbook.ru/catalog/newrologija/neurologyo/108371-detail

Skoromets OA, Skoromets GP, Skoromets TO, Thyssen TP Spinal angioneurology. A guide for doctors. – M: MEDpress-inform, 2003: 608 p. [in Russian]. URL: https://www.mmbook.ru/catalog/newrologija/neurologyo/101737-detail

Tishevskoy IA. Anatomy of the Central Nervous System: A Textbook. - Chelyabinsk: Izd-vo YuUrGU. 2000: 131 p. [in Russian]. URL: http://pedlib.ru/Books/4/0137/4_0137-1.shtml

Cherkasov VG, Kravchuk S.Yu. Human anatomy: textbook. – Vinnytsia: Nova Kniga, 2018: 640 p. [in Ukrainian]. URL: https://books.google.com.ua/books?id=tNmuCQAAQBAJ&printsec=frontcover&hl=ru#v=onepage&q&f=false

Aljishi M., Abernethy D. Spinal Cord Infarction // The New Zealand Medical Student Journal. 2015; 20: 18-21.

Bergui M., Ventilii G., Ferrio F.M., Daniele D.R. Spinal Cord Ischemia due to Vertebral Artery Dissection // Neuroradiol J. 2005 June 1; 18: 390-4. https://doi.org/10.1177%2F197140090501800318

Sherman P. M., Gailloud P. Artery of the Cervical Enlargement Originating from the Inferior Thyroid Artery: An Angiographic Observation // Journal of Vascular and Interventional Radiology. 2004; 15 (6): 648-50. https://doi.org/10.1016/S1051-0443(07)60341-8

Sobotta: Anatomie des Menschen. Der komplitte Atlas in einem Band / Herausgegeben von R. Putz und R. Rabst. – Urband & Fischer, 2007: 830 p. URL: https://1lib.eu/book/750446/a04ad5?regionChanged

Su W.-D., Ohtsuka A., Taguchi T., Murakami T. Typology of the Arteries in the Human Scalenus Region, with Special Reference to the Accessory Ascending Cervical Artery // Acta Med Okayama. 2000; 54 (6): 243-52. doi: https://doi.org/10.18926/AMO/32280.

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.