From the Research
The anterior spinal artery (ASA) supplies the anterior two-thirds of the spinal cord, including the anterior horns, corticospinal tracts, spinothalamic tracts, and the anterior portion of the lateral columns. This is based on the most recent and highest quality study available, which provides a detailed understanding of the vascular supply to the spinal cord 1. The ASA originates from the vertebral arteries at the level of the medulla oblongata and runs along the anterior median fissure of the spinal cord. It receives additional blood supply from radicular arteries at various levels, with the artery of Adamkiewicz being a particularly important contributor in the thoracolumbar region 2, 3.
The clinical significance of the ASA is evident in the anterior spinal artery syndrome, which occurs when the ASA is occluded, resulting in loss of motor function and pain/temperature sensation below the level of the lesion, while preserving proprioception, vibration sense, and light touch (which are supplied by the posterior spinal arteries) 4, 5. The watershed areas of the ASA are particularly vulnerable to ischemia during periods of hypoperfusion, explaining why certain spinal cord regions are more susceptible to infarction than others.
Key points to consider:
- The ASA supplies the anterior two-thirds of the spinal cord
- The ASA receives additional blood supply from radicular arteries, including the artery of Adamkiewicz
- Occlusion of the ASA results in anterior spinal artery syndrome, characterized by loss of motor function and pain/temperature sensation
- The watershed areas of the ASA are vulnerable to ischemia during periods of hypoperfusion.