PT  - JOURNAL ARTICLE
AU  - D.H. Heo
AU  - Y.J. Cho
AU  - S.H. Sheen
AU  - M.S. Hong
AU  - S.M. Cho
AU  - S.H. Park
TI  - 3D Reconstructions of Spinal Segmental Arteries Using CT Angiography: Applications in Minimally Invasive Spinal Procedures
AID  - 10.3174/ajnr.A2137
DP  - 2010 Oct 01
TA  - American Journal of Neuroradiology
PG  - 1635--1639
VI  - 31
IP  - 9
4099  - http://www.ajnr.org/content/31/9/1635.short
4100  - http://www.ajnr.org/content/31/9/1635.full
SO  - Am. J. Neuroradiol.2010 Oct 01; 31
AB  - BACKGROUND AND PURPOSE: Injury to spinal segmental arteries may potentially occur during spinal surgery, particularly during anterior or minimally invasive approaches. Use of a noninvasive radiologic tool to evaluate these arteries before surgery may reduce this risk. MATERIAL AND METHODS: We performed spinal CT angiography and reconstructed 3D images of segmental arteries in 41 patients. We classified the pathways and locations of the segmental arteries into 4 zones (A, B, C, and D) according to pedicle and vertebral endplates. We designated segmental arteries from T8 to L1 as “high-level segmental arteries” and those from L2 to L4, as “low-level segmental arteries.” We compared the distribution of segmental arteries between these 2 groups. We also investigated anatomic variations of segmental arteries and the rate of occurrence of the artery of Adamkiewicz. RESULTS: In all patients, 3D reconstruction images from spinal CT angiography clearly showed the pathways of segmental arteries on the vertebral bodies. Most of the segmental arteries passed the middle portion of the vertebral body (zones B and C). However, 51 of 738 segmental arteries (6.9%) had uncommon pathways (zones A and D), and segmental arteries from L2 to L4 had a higher incidence of uncommon pathways than higher level vertebrae (P < .05). We also observed 2 types of segmental artery anatomic variation, agenesis and dual supply. CONCLUSIONS: We suggest that spinal CT angiography can help to precisely visualize the spinal segmental arteries and surrounding bony structures and can aid clinicians in deciding on optimal approaches for spinal surgery.