During thoracoabdominal aortic aneurysm repair, the surgeon must identify and preserve the artery of Adamkiewicz to avoid anterior spinal artery syndrome. Which of the following correctly describes this artery?

• A It is a branch of the posterior spinal artery and arises at the C5-C6 level
• B It is a branch of the internal iliac artery and enters the sacral canal through the sacral hiatus
• C It arises from the basilar artery and supplies the upper cervical spinal cord
• D It typically arises from the left side between T9 and L2 and is the dominant radiculomedullary artery supplying the lower spinal cord ✓

Explanation

The artery of Adamkiewicz is the largest radiculomedullary artery and typically arises from the left side of the aorta between T9 and L2. It joins the anterior spinal artery and supplies the lower two-thirds of the spinal cord. Injury during aortic surgery causes anterior spinal syndrome with bilateral motor and pain/temperature loss but preserved proprioception. Option A is wrong because it is not a posterior spinal artery branch.

Reference: Gray's Anatomy, 42nd ed.

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Written and medically reviewed by the StethoPrep medical team.