Does the Adamkiewicz artery originate from the larger segmental arteries?

Objective: The Adamkiewicz artery supplies most of the blood to the anterio r spinal artery, which perfuses the anterior two thirds of the spinal cord. During operations for thoracoabdominal aortic aneurysm, detailed anatomic knowledge of the Adamkiewicz artery and its correlation with the intercosta l and/or lumbar arteries is important to prevent postoperative paraplegia, Methods: Minute dissection was performed on 102 formol-fixed adult cadavers without any history of circulatory disorders. The Adamkiewicz artery was f ound in the epidural space after laminectomy of the vertebrae. The entire c ourse between the Adamkiewicz artery and the intercostal and/or lumbar arte ry was dissected carefully, The vertebral level, laterality, and mean diame ter of all Adamkiewicz arteries were investigated. The correlation between the diameter of the Adamkiewicz artery and that of the intercostal and/or l umbar arteries was also determined. Results: The mean number of Adamkiewicz arteries per cadaver was 1.3 +/- 0.65, and the mean diameter was 0.77 +/- 0.24 mm (range, 0.50 to 1.49 mm), Approximately 70% of the Adamkiewicz arte ries originated from the intercostal and/or lumbar arteries on the left sid e, frequently at the T8-L1 vertebral level. There was no statistically sign ificant correlation between the diameter of the Adamkiewicz artery and that of intercostal and/or lumbar arteries. Conclusion: This study provides evi dence that, during operations on the thoracoabdominal aorta, the intercosta l and/or lumbar arteries should be preserved, regardless of their diameter, to pre rent postoperative paraplegia.