Ligation of Major Thoraco-Lumbar Spinal Cord Arteries in Monkeys

Abstract

I T HAS often been stated that occlusion of the radiculo-medullaris magna (ARMM), also called the arteria radicularis anterior magna, great anterior medullary artery, and of Adamkiewicz (Fig. 1 ), will cause severe ischemia of the lower spinal cord. 1,a,7,s,l~ Most of the evidence stems indirectly from clinical observations, mainly reports of paraplegia following aortic surgery and thoraco-lumbar sympathectomies. ~-a,7,1~ The pathological findings in these reports are inconclusive. In addition, there are very few experimental findings to support this statement. ~7 If the ARMM could be sacrificed without danger to the patient, it might have practical value in the neurosurgical management of spinal cord tumors and arteriovenous malformations? ,1',1~ During our experiments with spinal cord angiography in the monkey, we have developed a technique which enables us consistently to demonstrate the ARMM? ,6 We therefore decided to study the neurological consequences of ARMM ligation. As part of this study we also ligated the anterior spinal artery above and below its junction with the ARMM. In a single monkey both the ARMM and proximal anterior spinal artery were ligated.