The lateral spinal artery of the upper cervical spinal cord

TLDR

The lateral spinal artery is the most rostral segment of the spinal cord’s posterolateral arterial system, supplying the posterior and lateral cord, running anterior to the posterior roots of C1–C4 and posterior to the dentate ligament, and anastomosing with PICA and extraspinal arteries, with variations such as vertebral duplication and atypical PICA origins. Understanding these arterial variations informs the anatomical nuances and angiographic significance of the upper cervical spinal cord.

Abstract

✓ The lateral spinal artery corresponds to the most rostral extent of the posterolateral arterial axis of the spinal cord. It supplies the posterior and lateral aspects of the spinal cord, and courses anterior to the posterior roots of the upper cervical spinal nerves (C-1 to C-4), and posterior to the dentate ligament. The lateral spinal artery anastomoses rostrally with the branches of the posterior inferior cerebellar artery (PICA) at the restiform body and laterally with the extraspinal arteries at the emergence of each nerve. It may originate either from the vertebral artery or from the PICA lateral to the medulla. Certain variations will cause an unusual but normal enlargement of the vessel in a specific portion of its course; these variations include vertebral artery duplication, a C-1 or C-2 vertebral origin of the PICA, a C-1 or C-2 occipital origin of the PICA, and an intradural course of the vertebral artery at C-2. Knowledge of these variations in the arterial supply to the area allows for an understanding of the different anatomic peculiarities present and their angiographic importance.