A 70-year-old man with metastatic prostate cancer to bone develops acute onset paraplegia. MRI reveals T10 vertebral body collapse with retropulsion of bone into the spinal cord. The artery of Adamkiewicz (artery radicularis magna) is critical for spinal cord blood supply. From which side does this artery most commonly arise?
- A Right side, between T9 and T12
- B Right side, between L1 and L2
- C Left side, between T9 and T12 ✓
- D Left side, between L1 and L2
Correct answer: C. Left side, between T9 and T12
Explanation
The artery of Adamkiewicz most commonly arises from the left side (approximately 80% of individuals) between T9 and T12, though it can arise anywhere from T8 to L3. It supplies the lower two-thirds of the spinal cord. Damage during thoracoabdominal aortic surgery or spinal procedures can cause anterior spinal artery syndrome with paraplegia and dissociated sensory loss. The left-sided predominance is important for surgical planning.
Reference: Snell's Clinical Anatomy by Regions, 10th ed.
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Written and medically reviewed by the StethoPrep medical team.