Intraspinal vascular perfusion territories of the descending thoracic aorta.

OBJECTIVES

Our study aims at characterizing the intraspinal vascular perfusion territories (angiosomes) of the descending thoracic aorta in a cadaver stetting to understand the principles of blood supply to the spinal cord and to provide the anatomic basis for strategies to avoid spinal ischaemia during aorta surgery.

METHODS

Simulating blood flow in the descending thoracic aorta and thoracic aortic segmental arteries T3-T11 of 8 body donors were perfused with dyed liquids to label the epidural and spinal cord angiosomes.

RESULTS

The cranial and caudal borders of the spinal cord angiosome varied substantially with a maximum extension from segment C7 to the conus medullaris. In 5 specimens, the anterior and posterior aspects differed for 1-2 segments. In 75%, the anterior spinal artery appeared to be stained along the entire spinal cord, and in 4 specimens, a voluminous Adamkiewicz artery joined its lower thoracic segments. In 3 of those specimens, this caused the spinal cord angiosome to be stained caudally towards the conus medullaris. In addition to details on the spinal cord angiosome, details on the epidural angiosome and the antero- and retrograde perfusion of the spinal nerve roots and the influence of thoracic aortic segmental artery variations are provided.

CONCLUSIONS

Our study characterizes both intraspinal descending thoracic aorta angiosomes. It demonstrates the importance of the Adamkiewicz and the anterior spinal arteries for blood supply to the spinal cord and the nerve root fibers.