All blood vessels supplying the spinal cord can be divided into two groups - longitudinal arteries and segmental arteries.

The longitudinal vessels are located on the external surface of the spinal cord, and they extend in the vertical direction throughout its length.

In contrast, the segmental arteries are horizontally-directed, and they enter the vertebral canal via the intervertebral foramina.

Longitudinal arteries

The longitudinal arteries include the following blood vessels:

Anterior spinal artery - a single artery that arises from the anastomosis between two anterior spinal branches of each vertebral artery (its intracranial part); it descends along the anterior median fissure and supplies the anterior two-thirds of the spinal cord; its branches enter the spinal cord through the anterior median fissure and are called the sulcal arteries;
Posterior spinal arteries - two arteries that branch off each intracranial vertebral artery and descend along the right posterolateral sulcus and left posterolateral sulcus; they supply the posterior one-third of the spinal cord.

The anterior and posterior spinal arteries are connected by pial anastomoses and pial plexuses that originate from the pia mater, one of the spinal meninges (the innermost layer).

These anastomoses and plexuses are called arterial vasocorona, and they encircle the spinal cord and supply its lateral aspects.

Segmental arteries

The segmental arteries include the segmental spinal arteries that originate from different vessels within different regions of the spinal cord:

From the deep cervical artery and ascending cervical artery and vertebral arteries in the cervical region;
From the posterior intercostal arteries and subcostal artery in the thoracic region;
From the lumbar arteries in the lumbar region.

When reaching the vertebral canal, the segmental spinal arteries further branch into several smaller vessels:

Anterior radicular artery and posterior radicular artery - supply the anterior and posterior roots of the spinal nerves;
Anterior segmental medullary artery and posterior segmental medullary artery - directly flow into the anterior and posterior spinal arteries.

Note: The largest segmental medullary artery is the great anterior radiculomedullary artery (artery of Adamkiewicz), and it arises between the T8 / T9 and L2 levels. The artery of Adamkiewicz supplies the lumbosacral enlargement of the spinal cord.

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Arterial blood supply of spinal cord