Adamkiewicz

Adamkiewicz refers to the great radicular artery of the spinal cord, also known as the arteria radicularis magna. It is named after Albert Wojciech Adamkiewicz, who described it in the late 19th century. This artery is the largest anterior segmental medullary artery and plays a key role in reinforcing the anterior spinal artery to supply the lower thoracic and lumbar spinal cord.

Anatomy and variation: The Adamkiewicz artery typically arises on the left side from a posterior intercostal artery, most often between the T9 and T12 levels, but its origin is variable. It enters the spinal canal through the intervertebral foramen and joins the anterior spinal artery, providing a major source of blood to the lower two-thirds of the spinal cord. The presence, size, and exact course of the artery can vary between individuals, and some people may have multiple radicular arteries rather than a single dominant vessel.

Physiology and clinical relevance: As a principal supplier to the lower spinal cord, occlusion or compromise of the Adamkiewicz artery can lead to spinal cord ischemia and potentially paraplegia, particularly during thoracoabdominal aortic surgery or endovascular repair. Surgeons and interventionalists strive to identify and preserve this artery when feasible and to maintain adequate spinal cord perfusion through surgical planning and perioperative strategies, including optimization of blood pressure and consideration of adjuncts such as staged procedures or spinal drainage.

History: The artery is named for Adamkiewicz, who first described its significance in the context of spinal cord blood supply in the late 19th century.