The Cervical Arteries: An Anatomical Study with Application to Avoid the Nerve Root and Spinal Cord Blood Supply

AIM: Injury to the vascular supply to the cervical spinal cord can lead to the anterior spinal artery syndrome, which is often associated with transforaminal corticosteroid injections to the cervical foramina. The purpose of this cadaveric study was to examine the morphology of the cervical arteries and to emphasize their clinical importance. MATERIAL and METHODS: Five formalin-fixed human cadavers were used to determine the morphology of the radicular arteries from the vertebral, ascending and deep cervical arteries in the cervical foraminal region. RESULTS: The mean diameter of the vertebral arteries was 5.50 mm. The radicular arteries arose from the vertebral artery originating from its posterior aspect at each level and the C6 radicular artery was larger in diameter than others. Their diameters ranged from 0.75 mm to 1.02 mm. The mean diameter of the ascending cervical artery was 1.5 mm (range 1.21 to 1.80 mm). Its arising spinal branches were located at the C3-4 or C4-5 levels. The diameters of radicular branches arising from the ascending cervical artery ranged from 0.80 mm to 1.40 mm. The mean diameter of the deep cervical artery was 1.71 mm (range 1.3 to 2.1 mm) and was usually slightly larger than the ascending cervical arteries. These deep cervical radicular arteries always entered the C5-6, C6-7 and C7-T1 foramens and those of the radicular branches arising from the deep cervical artery ranged from 0.43 mm to 1.49 mm (mean, 1.08 mm). CONCLUSION: Understanding the vascular supply to the cervical spinal cord is important for preventing serious complications such as spinal cord ischemia.