Hermann Adonis N'da1, Louis Chenin2, Cyril Capel2, Eric Havet3, Daniel Le Gars2,3, Johann Peltier2,3. 1. Service de Neurochirurgie, Centre Hospitalier Universitaire d'Amiens Nord, Place Victor Pauchet, 80054, Amiens Cedex 01, France. beakloui@gmail.com. 2. Service de Neurochirurgie, Centre Hospitalier Universitaire d'Amiens Nord, Place Victor Pauchet, 80054, Amiens Cedex 01, France. 3. Laboratoire d'Anatomie et d'Organogénèse, Université de Picardie Jules Verne, 80036, Amiens Cedex 1, France.
Abstract
PURPOSE: The aim of this study is to describe the anterior spinal artery-Adamkiewicz artery (ASA-AKA) junction and establish a classification allowing defining the neurological risk in either thoracoabdominal aorta aneurysm treatment and in anterior or transforaminal thoracolumbar spine surgery. METHODS: Fifteen spinal cords of fresh cadavers were dissected. Both lumbar arteries and ASA were injected with strongly diluted red-colored silicon. RESULTS: The dural crossing of AKA was located on the left side in 86 % of cases, between T8 and T10 in 73.33 % of cases and L1-L2 in 26.67 % of cases. The average diameter of the ascending branch of AKA was 1.10 mm (range 0.8-1.9 mm), and its average length was 30.27 mm (range 12.3-60 mm). The AKA's arch average diameter was 11.3 mm (range 9-20 mm) with an open downward angle average of 20.1° (range 11°-30°). The descending branch of AKA which was a continuation of ASA had an average diameter of 1.33 mm (range 0.8-1.86 mm). The ASA at the top of the arch had an average diameter of 0.74 mm (range 0.2-1.77 mm). According to these findings, we have proposed a new classification with two types of junctions. The type I and its variant correlated to high neurological risk were present in 93.33 % of cases. The type II, correlated to medium or low neurological risk, was present in 6.67 % of cases. CONCLUSION: These anatomical findings allow a planning of the neurological risk before thoracoabdominal aorta aneurysm or thoracolumbar anterior or transforaminal spine surgery.
PURPOSE: The aim of this study is to describe the anterior spinal artery-Adamkiewicz artery (ASA-AKA) junction and establish a classification allowing defining the neurological risk in either thoracoabdominal aorta aneurysm treatment and in anterior or transforaminal thoracolumbar spine surgery. METHODS: Fifteen spinal cords of fresh cadavers were dissected. Both lumbar arteries and ASA were injected with strongly diluted red-colored silicon. RESULTS: The dural crossing of AKA was located on the left side in 86 % of cases, between T8 and T10 in 73.33 % of cases and L1-L2 in 26.67 % of cases. The average diameter of the ascending branch of AKA was 1.10 mm (range 0.8-1.9 mm), and its average length was 30.27 mm (range 12.3-60 mm). The AKA's arch average diameter was 11.3 mm (range 9-20 mm) with an open downward angle average of 20.1° (range 11°-30°). The descending branch of AKA which was a continuation of ASA had an average diameter of 1.33 mm (range 0.8-1.86 mm). The ASA at the top of the arch had an average diameter of 0.74 mm (range 0.2-1.77 mm). According to these findings, we have proposed a new classification with two types of junctions. The type I and its variant correlated to high neurological risk were present in 93.33 % of cases. The type II, correlated to medium or low neurological risk, was present in 6.67 % of cases. CONCLUSION: These anatomical findings allow a planning of the neurological risk before thoracoabdominal aorta aneurysm or thoracolumbar anterior or transforaminal spine surgery.
Authors: Ansgar Berlis; Kai-Michael Scheufler; Christian Schmahl; Sebastian Rauer; Friedrich Götz; Martin Schumacher Journal: AJNR Am J Neuroradiol Date: 2005-02 Impact factor: 3.825