ABSTRACT

Purpose:

The importance of preserving Adamkiewicz artery which originates in the lumbar artery during replacement of the thoracoabdominal aorta is debated.

The purpose of the present study is to examine the morphology of lumbar arteries and to determine their clinical importance.

Methods:

We dissected 10 male and 5 female cadavers obtained from the anatomy laboratory of the Medical School of the Gulhane Military Medical Academy. The age of the cadavers ranged from 40 to 70 years, average age 52. After having determined the level of aortic bifurcation, we measured the distance from that point to the origin of the lumbar arteries. Right and left lumbar arteries origin levels, diameters and the distance between them, as well as abdominal aorta diameter were measured.

Results:

The comparison of the diameters of the right and left lumbar arteries with diameter of the abdominal aorta was found to be statistically significant, also, the difference in the diameter of the second left lumbar artery was found to be significantly different from the other left lumbar arteries. However, we did not find a statistically significant difference and ratio diameters of the left and right lumbar arteries. Furthermore, we determined as statistically significant the distance between the left renal artery and the right and left lumbar arteries at the level of the abdominal aorta. We established that the difference between the second and third lumbar arteries of the fourth lumbar artery pair was statistically different. The lumbar arteries were observed in five pairs in four cadavers.

Conclusion:

In conclusion, it was observed that they had different locations and, diameters, and that distances between each pair were different. It was also seen that each pair sometimes originated from the common trunk of the abdominal aorta. All data were evaluated statistically and morphological differences were found in the morphology of lumbar arteries and it is believed that these differences may be of clinical importance. During operations for aortal aneurysm, disc hernia and tumors of spinal cord, detailed anatomical knowledge of the Adamkiewicz artery and its correlation with the intercostals and/or lumbar arteries is important to prevent postoperative paraplegia.