Functional Vascular Anatomy and Arteriovenous Shunts of the Spine

Abstract

The history of vascular anatomy of the spinal cord and spine began in the late 19th century. With recent advances in endovascular and surgical treatment of vascular lesions of the spinal cord, understanding the vascular anatomy of the spinal cord has become more important than ever. Catheter angiography is the gold standard for diagnosing vascular lesions of the spinal cord, and the vascular architecture of the spinal cord itself is relatively simple, a repetition of basic longitudinal and axial structures. This review discusses the vascular anatomy of the spine and spinal cord from the embryological point of view, as well as an overview of typical spinal arteriovenous shunt diseases mainly depending on their locations: paraspinal, epidural, dural, perimedullary, intramedullary, filum terminale/cauda equina, craniocervical junction, and related diseases.

Keywords

functional anatomy - embryology - arteriovenous shunt - spine - spinal cord

Publikationsverlauf

Artikel online veröffentlicht:
03. August 2023

• References

• 1 Groen RJM, Grobbelaar M, Muller CJF. et al. Morphology of the human internal vertebral venous plexus: a cadaver study after latex injection in the 21-25-week fetus. Clin Anat 2005; 18 (06) 397-403
• 2 Diaz-Cuadros M, Wagner DE, Budjan C. et al. In vitro characterization of the human segmentation clock. Nature 2020; 580 (7801) 113-118
• 3 Pourquie O. The vertebrate segmentation clock. J Anat 2001; 199 (Pt 1-2): 169-175
• 4 Schoenwolf G, Bleyl S, Brauer P, Francis-West P. Larsen's Human Embryology. 5th ed. Elsevier; 2015
• 5 Costa Almeida L, de Souza Figueiredo YJ, Pinheiro Zylberman A, Garção DC. Ascent of the conus medullaris in human foetuses: a systematic review and meta-analysis. Sci Rep 2022; 12 (01) 12659
• 6 Lazorthes G, Gouaze A, Zadeh JO, Santini JJ, Lazorthes Y, Burdin P. Arterial vascularization of the spinal cord. Recent studies of the anastomotic substitution pathways. J Neurosurg 1971; 35 (03) 253-262
• 7 Evans H. The development of the vascular system. In: In Manual of Human Embryology. J.B. Lippincott Co.; 1912: 570-709
• 8 Gregg L, Gailloud P. Neurovascular anatomy; spine. In: Hetts S, Cooke D. eds. Handbook of Clinical Neurology. Elsevier B.V.; 2021: 33-47
• 9 Manelfe C, Lazorthes G, Roulleau J. Arteries of the human spinal dura mater. [Article in French]. Acta Radiol Diagn (Stockh) 1972; 13 (00) 829-841
• 10 Bosmia AN, Hogan E, Loukas M, Tubbs RS, Cohen-Gadol AA. Blood supply to the human spinal cord: part I. Anatomy and hemodynamics. Clin Anat 2015; 28 (01) 52-64
• 11 Lasjaunias P, Berensterin A, ter Brugge KG. Surgical Neuroangiography. Clinical Vascular Anatomy and Variations. Vol. 1. 2nd ed. New York: Springer; 2001
• 12 Zawiliński J, Litwin JA, Nowogrodzka-Zagórska M, Gorczyca J, Miodoński AJ. Vascular system of the human spinal cord in the prenatal period: a dye injection and corrosion casting study. Ann Anat 2001; 183 (04) 331-340
• 13 Sakka L, Gabrillargues J, Coll G. Anatomy of the spinal meninges. Oper Neurosurg (Hagerstown) 2016; 12 (02) 168-188
• 14 Griessenauer CJ, Raborn J, Foreman P, Shoja MM, Loukas M, Tubbs RS. Venous drainage of the spine and spinal cord: a comprehensive review of its history, embryology, anatomy, physiology, and pathology. Clin Anat 2015; 28 (01) 75-87
• 15 Gregg L, Gailloud P. Transmedullary venous anastomoses: anatomy and angiographic visualization using flat panel catheter angiotomography. AJNR Am J Neuroradiol 2015; 36 (07) 1381-1388
• 16 Niimi Y, Berenstein A, Fernandez PM, Brisman JL, Song JK. Pediatric nonvertebral paraspinal arteriovenous fistulas along the segmental nerve: clinical, imaging, and therapeutic considerations. J Neurosurg 2005; 103 (02) 156-162
• 17 Kim LJ, Spetzler RF. Classification and surgical management of spinal arteriovenous lesions: arteriovenous fistulae and arteriovenous malformations. Neurosurgery 2006; 59 (05, Suppl 3): S195-S201 , discussion S3–S13
• 18 Veznedaroglu E, Nelson PK, Jabbour PM, Rosenwasser RH. Endovascular treatment of spinal cord arteriovenous malformations. Neurosurgery 2006; 59 (05, Suppl 3): S202-S209 , discussion S3–S13
• 19 Mizutani K, Consoli A, Maria FD. et al. Intradural spinal cord arteriovenous shunts in a personal series of 210 patients: novel classification with emphasis on anatomical disposition and angioarchitectonic distribution, related to spinal cord histogenetic units. J Neurosurg Spine 2021; 34: 1-11
• 20 Rodesch G, Lasjaunias P. Spinal cord arteriovenous shunts: from imaging to management. Eur J Radiol 2003; 46 (03) 221-232
• 21 Cognard C, Semaan H, Bakchine S. et al. Paraspinal arteriovenous fistula with perimedullary venous drainage. AJNR Am J Neuroradiol 1995; 16 (10) 2044-2048
• 22 Consoli A, Coskun O, Di Maria F. et al. Spinal cord arterio-venous shunts: From classification to therapeutic management. Rev Neurol (Paris) 2021; 177 (05) 469-476
• 23 Kitagawa RS, Mawad ME, Whitehead WE, Curry DJ, Luersen TG, Jea A. Paraspinal arteriovenous malformations in children. J Neurosurg Pediatr 2009; 3 (05) 425-428
• 24 Lasjaunias P, Berensterin A, ter Brugge KG. Surgical Neuroangiography. 2nd ed. New York: Springer; 2006
• 25 Elkordy A, Endo T, Sato K, Sonoda Y, Takahashi A, Tominaga T. Exclusively epidural spinal metameric arteriovenous shunts: case report and literature review. Spine J 2015; 15 (03) e15-e22
• 26 Ramanathan D, Levitt MR, Sekhar LN, Kim LJ, Hallam DK, Ghodke BV. Management of spinal epidural arteriovenous fistulas: interventional techniques and results. J Neurointerv Surg 2014; 6 (02) 144-149
• 27 Huang W, Gross BA, Du R. Spinal extradural arteriovenous fistulas: clinical article. J Neurosurg Spine 2013; 19 (05) 582-590
• 28 Lasjaunias P, Berenstein A. Surgical Neuroangiography. Part 3. Functional Vascular Anatomy of the Brain, Spinal Cord and Spine. Berlin, Germany: Springer-Verlag; 1990
• 29 Kiyosue H, Matsumaru Y, Niimi Y. et al; JSNET Spinal AV Shunts Study Group. Angiographic and clinical characteristics of thoracolumbar spinal epidural and dural arteriovenous fistulas. Stroke 2017; 48 (12) 3215-3222
• 30 Heier LA, Lee BCP. A dural spinal arteriovenous malformation with epidural venous drainage: a case report. AJNR Am J Neuroradiol 1987; 8 (03) 561-563
• 31 Marshman LAG, David KM, Chawda SJ. Lumbar extradural arteriovenous malformation: case report and literature review. Spine J 2007; 7 (03) 374-379
• 32 Kiyosue H, Tanoue S, Okahara M, Hori Y, Kashiwagi J, Mori H. Spinal ventral epidural arteriovenous fistulas of the lumbar spine: angioarchitecture and endovascular treatment. Neuroradiology 2013; 55 (03) 327-336
• 33 Brinjikji W, Yin R, Nasr DM, Lanzino G. Spinal epidural arteriovenous fistulas. J Neurointerv Surg 2016; 8 (12) 1305-1310
• 34 Aljobeh A, Sorenson TJ, Bortolotti C, Cloft H, Lanzino G. Vertebral arteriovenous fistula: a review article. World Neurosurg 2019; 122: e1388-e1397
• 35 Beaujeux RL, Reizine DC, Casasco A. et al. Endovascular treatment of vertebral arteriovenous fistula. Radiology 1992; 183 (02) 361-367
• 36 Fugate JE, Lanzino G, Rabinstein AA. Clinical presentation and prognostic factors of spinal dural arteriovenous fistulas: an overview. Neurosurg Focus 2012; 32 (05) E17
• 37 Marcus J, Schwarz J, Singh IP. et al. Spinal dural arteriovenous fistulas: a review. Curr Atheroscler Rep 2013; 15 (07) 335
• 38 Krings T, Geibprasert S. Spinal dural arteriovenous fistulas. AJNR Am J Neuroradiol 2009; 30 (04) 639-648
• 39 Komiyama M. Spinal radiculomedullary vein and bridging vein. Interv Neuroradiol 2020; 26 (06) 703-705
• 40 Biondi A, Merland JJ, Reizine D. et al. Embolization with particles in thoracic intramedullary arteriovenous malformations: long-term angiographic and clinical results. Radiology 1990; 177 (03) 651-658
• 41 Mourier KL, Gobin YP, George B, Lot G, Merland JJ. Intradural perimedullary arteriovenous fistulae: results of surgical and endovascular treatment in a series of 35 cases. Neurosurgery 1993; 32 (06) 885-891 , discussion 891
• 42 Spetzler RF, Detwiler PW, Riina HA, Porter RW. Modified classification of spinal cord vascular lesions. J Neurosurg 2002; 96 (02) 145-156
• 43 Rodesch G, Hurth M, Alvarez H, Tadie M, Lasjaunias P. Spinal cord intradural arteriovenous fistulae: anatomic, clinical, and therapeutic considerations in a series of 32 consecutive patients seen between 1981 and 2000 with emphasis on endovascular therapy. Neurosurgery 2005; 57 (05) 973-983 , discussion 973–983
• 44 Li J, Zeng G, Zhi X. et al. Pediatric perimedullary arteriovenous fistula: clinical features and endovascular treatments. J Neurointerv Surg 2019; 11 (04) 411-415
• 45 Namba K. Vascular anatomy of the cauda equina and its implication on the vascular lesions in the caudal spinal structure. Neurol Med Chir (Tokyo) 2016; 56 (06) 310-316
• 46 Namba K, Niimi Y, Ishiguro T, Higaki A, Toma N, Komiyama M. Cauda equina and filum terminale arteriovenous fistulas: anatomic and radiographic features. AJNR Am J Neuroradiol 2020; 41 (11) 2166-2170
• 47 Giordan E, Brinjikji W, Ciceri E, Lanzino G. Arteriovenous fistulae of the filum terminale. J Neurointerv Surg 2018; 10 (02) 191-197
• 48 Djindjian M, Ribeiro A, Ortega E, Gaston A, Poirier J. The normal vascularization of the intradural filum terminale in man. Surg Radiol Anat 1988; 10 (03) 201-209
• 49 Hiramatsu M, Sugiu K, Hishikawa T. et al. Epidemiology of dural arteriovenous fistula in Japan: analysis of Japanese registry of neuroendovascular therapy (JR-NET2). Neurol Med Chir (Tokyo) 2014; 54: 63-71
• 50 Reinges MHT, Thron A, Mull M, Huffmann BC, Gilsbach JM. Dural arteriovenous fistulae at the foramen magnum. J Neurol 2001; 248 (03) 197-203
• 51 Wang JY, Molenda J, Bydon A. et al. Natural history and treatment of craniocervical junction dural arteriovenous fistulas. J Clin Neurosci 2015; 22 (11) 1701-1707
• 52 Hiramatsu M, Sugiu K, Ishiguro T. et al. Angioarchitecture of arteriovenous fistulas at the craniocervical junction: a multicenter cohort study of 54 patients. J Neurosurg 2018; 128 (06) 1839-1849
• 53 Bhattacharya JJ, Luo CB, Suh DC, Alvarez H, Rodesch G, Lasjaunias P. Wyburn-Mason or Bonnet-Dechaume-Blanc as cerebrofacial arteriovenous metameric syndromes (CAMS). A new concept and a new classification. Interv Neuroradiol 2001; 7 (01) 5-17
• 54 Etchevers HC, Vincent C, Le Douarin NM, Couly GF. The cephalic neural crest provides pericytes and smooth muscle cells to all blood vessels of the face and forebrain. Development 2001; 128 (07) 1059-1068
• 55 Rodesch G, Hurth M, Alvarez H, Tadié M, Lasjaunias P. Classification of spinal cord arteriovenous shunts: proposal for a reappraisal – the Bicêtre experience with 155 consecutive patients treated between 1981 and 1999. Neurosurgery 2002; 51 (02) 374-379 , discussion 379–380