Artery of Adamkiewicz

Dr Tom Foster and Dr Henry Knipe et al.

The artery of Adamkiewicz, also known as the great anterior radiculomedullary artery or arteria radicularis anterior magna, is the name given to the dominant thoracolumbar segmental artery that supplies the spinal cord.

The artery of Adamkiewicz has a variable origin but most commonly arises 1:

  • on the left (~80%)
  • at the level of the 9th-12th intercostal artery (~70%)

It arises from the radiculomedullary branch of the posterior branch of the intercostal or lumbar artery, which arises from the thoracic or abdominal aorta respectively 1. It has a diameter of ~1 mm (range 0.8-1.3 mm) 1,4

  • ascends on the mid-sagittal anterior surface of the spinal cord, usually less than two-and-a-half vertebral body lengths, with an identifying "hairpin turn" at its anastomosis with the anterior spinal artery 1,2,4
  • has a straight course, compared to the anterior radiculomedullary vein, which is more tortuous 4

As outlined above the origin of the artery of Adamkiewicz is quite variable and can extend from mid-thoracic to lumbar levels 3:

  • lumbar arteries at the level of L1 or L2 (10%)
  • intercostal arteries at the level of T5 to T8 (15%)
    • may arise from intercostobronchial trunk (ICBT)
  • arises on the right (20%)

On CTA, it appears as a continuous vascular structure running from an intercostal or lumbar artery to the anterior spinal artery via the radiculomedullary artery with its characteristic course 2.

The distal anterior spinal cord vascular territory is at risk of ischemia or infarction if there is damage to the artery of Adamkiewicz from pathology (e.g. AAA, dissection, malignancy, vascular malformations) or intervention (e.g. AAA repair, spinal surgery, angiography) 1-2.

It is named after Albert Wojciech Adamkiewicz (1850-1921), a Polish physician and neuropathologist 5.

Anatomy: Spine

Article information

rID: 26389
Section: Anatomy
Tag: artery
Synonyms or Alternate Spellings:
  • Artery of the lumbar enlargement
  • Major anterior segmental medullary artery
  • Great anterior radiculomedullary artery
  • Arteria radicularis anterior magna
  • Adamkiewicz artery
  • Artery of adamkiewitz
  • Artery of adamkewitz
  • Artery of ademkiewicz

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Cases and figures

  • Case 1: occlusion by aortic dissection.
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  • Spinal AVM
    Case 2: Spinal arteriovenous malformation
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