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Updated: Nov 27, 2025

Author Spotlight: Enhancing Success of Ultrasound-Guided Neuraxial Anesthesia in Cases with Difficult Anatomy
Published on: January 31, 2025
Neurovascular anatomy: Spine
Lydia Gregg1, Philippe Gailloud1
1Division of Interventional Neuroradiology and Department of Art as Applied to Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States.
Abstract:
The arterial supply of the spinal cord is provided by the spinal branch of the cervical, thoracic, and lumbar intersegmental arteries. While supply is initially provided at each embryonic segment, only a few prominent anterior radiculomedullary arteries remain at the adult stage, including the arteries of the cervical and lumbosacral enlargements as well as a constant upper thoracic contributor. The spinal cord is surrounded by the vasocorona, an arterial network that includes several longitudinal anastomotic chains, notably the anterior and posterior spinal arteries, which respectively supply the central and peripheral components of the intrinsic vascularization. The intrinsic venous circulation is also divided into central and peripheral components. The perimedullary venous system includes several longitudinal anastomotic chains interconnected by the coronary plexus. The radiculomedullary veins loosely follow the spinal nerve roots on their way to the epidural plexus. Their point of passage through the thecal sac forms an important valve-like structure, the antireflux mechanism.
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