From the Department of Neurosurgery (V.H.P.P.), Instituto de Ciencias Forenses, TSJ Ciudad de México, Centro Medico Siglo XXI, Mexico City, Mexico.
Department of Neurosurgery (H.J.), International Center for Neurosurgery, Henan Provincial People's Hospital, Zhengzhou, China.
AJNR Am J Neuroradiol. 2019 Dec;40(12):2010-2015. doi: 10.3174/ajnr.A6304. Epub 2019 Nov 21.
Although considerable variability exists as to the overall caliber of radiculomedullary arteries, dominant radiculomedullary arteries such as the artery of Adamkiewicz exist. The existence of a great posterior radiculomedullary artery has attracted little attention and has been a matter of debate. The aim of this anatomic study was to determine the presence or absence of the great posterior radiculomedullary artery.
We performed microsurgical dissection on formaldehyde-fixed cadaveric human spinal cords. The artery of Adamkiewicz in the spinal cord specimens ( = 50) was injected with colored latex until the small-caliber arterial vessels were filled and the great posterior radiculomedullary artery was identified. The course, diameter, and location of great posterior radiculomedullary artery were documented.
A great posterior radiculomedullary artery was identified in 36 (72%) spinal cord specimens. In 11 (22%) specimens, bilateral great posterior radiculomedullary arteries were present. In 13 cases (26%), a unilateral left-sided great posterior radiculomedullary artery was identified. In 11 cases (22%), a unilateral right-sided great posterior radiculomedullary artery was identified. In 1 specimen (2%), 3 right-sided great posterior radiculomedullary arteries were noted. The average size of the great posterior radiculomedullary arteries was 0.44 mm (range, 0.120-0.678 mm on the left and 0.260-0.635 mm on the right).
A great posterior radiculomedullary artery is present in most (72%) individuals. The authors describe the microsurgical anatomy of the great posterior radiculomedullary artery with emphasis on its morphometric parameters as well as its implications for spinal cord blood supply. Variations of the arterial supply to the dorsal cord are of great importance due to their implications for ischemic events, endovascular procedures, and surgical approaches.
尽管脊神经根动脉的整体口径存在很大差异，但像 Adamkiewicz 动脉这样的主导脊神经根动脉是存在的。大后脊神经根动脉的存在引起的关注较少，并且一直存在争议。本解剖研究的目的是确定是否存在大后脊神经根动脉。
我们对甲醛固定的人体脊髓尸体标本进行了显微外科解剖。在脊髓标本（共 50 个）中注入有色乳胶，直到小口径动脉血管充满，并识别出大后脊神经根动脉。记录大后脊神经根动脉的走行、直径和位置。
在 36 个（72%）脊髓标本中发现了大后脊神经根动脉。在 11 个（22%）标本中，双侧大后脊神经根动脉存在。在 13 例（26%）中，发现单侧左侧大后脊神经根动脉。在 11 例（22%）中，发现单侧右侧大后脊神经根动脉。在 1 例（2%）中，发现 3 个右侧大后脊神经根动脉。大后脊神经根动脉的平均大小为 0.44mm（左侧范围为 0.120-0.678mm，右侧范围为 0.260-0.635mm）。
大多数（72%）个体存在大后脊神经根动脉。作者描述了大后脊神经根动脉的显微外科解剖，重点介绍了其形态计量参数及其对脊髓血液供应的影响。由于对缺血事件、血管内操作和手术入路的影响，背侧脊髓动脉供应的变异具有重要意义。
