Blood Supply of Spinal Cord

The blood supply of spinal cord is mainly dependent on three vessels. These are namely anterior median longitudinal arterial trunk and a pair of posterolateral trunks. These posterolateral trunks are situated near posterior nerve rootlets.

These longitudinal arterial trunks are largest in size in cervical and lumbar regions because the demand of grey matter is much more than white matter.

The size is much smaller in thoracic regions because of the same reason.

Generally speaking the blood supply of spinal cord in thoracic area is poor as compared to cervical and lumbar region. The blood supply of spinal cord  is poorest between levels T4 and T9.

However, these are not the sole vessels on which blood supply of  spinal cord is dependent. There are many other reinforcing vessels. A list of other vessels supplying the spinal cord is as follows.

Blood Supply of Spinal Cord from Radicular Arteries of The Cord

Also called medullary feeder arteries, these reinforce the longitudinal arterial channels.

These vary from 2-17 on anterior side and 6-25 on posterior side.

The vertebral arteries supply 80% of feeder arteries in the neck. In thoracic and lumbar areas the aorta gives rise to these vessels. In sacral area,  iliolumbar arteries, fifth lumbar arteries, middle sacral arteries and lateral sacral arteries are important sources.

Blood Supply of Spinal Cord from Vertebtral and Posteroinferior Cerebellar Arteries

These form additional important source of blood supply in cervical region.

Segmental Arteries

Segmental arteries are at every level of spine and occur in pairs. These supply both spinal and extraspinal tissues.

They originate from vertebral arteries in neck, aorta in  thoracolumbar area andf lateral sacral artery in sacral region.

In few people ascending pharyngeal artery is an important source of segmental arteries.

The segmental arteries branch profusely at intervertebral foramen and a second anastomosis occurs within spinal canal in extradural regioin.

This anastomosis forms a rich network of vessels and allows to ligate segmental arteries without affecting the circulation of the cord.

Artery of AdamKiewz

It is the largest feeder of lumbar part of spinal cord. It is on the left side between T9-T11 vertebrae in almost 80% of the people.

Venous Drainage

Venous drainage of the spinal cord is not as clearly defined as arterial circulation and can be highly variable.

Generally speaking, there are two sets of vessels

• Veins of spinal cord
• Venous plexus of Batson

Veins of spinal cord are small veins and form a small component of the venous system. they drain into Batson plexus.

Batson plexus is a  large and complex venous channel communicating directly with inferior and superior venae cavae. It extends from base of skull to coccyx. The Batson plexus has three components

• Extradural venous plexus
• Extravertebral venous plexus
• Veins to osseous structures of spine

The longitudinal venous trunks are called anterior and posterior venous channels.

Clinical Significance of Blood Supply of Spinal Cord

The knowledge of arterial circulation is important during surgical procedures. As for as possible the blood supply to the cord should be preserved.

As venous system communicates directly with large vessels, this interconnection allows metastatic spread from pelvis to vertebral column.