The Legacy of the Artery of Adamkiewicz: Historical Significance and Its Impact on Modern Neurosurgery

Introduction: The Artery of Adamkiewicz (AoA), first identified in 1882 by Albert Adamkiewicz, holds an essential place in the annals of neurovascular and spinal surgery. For decades, its significance was misunderstood or underestimated, leading to unfavorable outcomes during procedures that unknowingly compromised spinal cord perfusion. Today, the AoA stands as a pivotal focus in the planning and execution of complex interventions. This study revisits the AoA’s historical discovery and examines how modern techniques in imaging and surgery have reshaped its role in clinical practice.

Methods: We conducted a comprehensive review of the literature, tracing the evolution of the AoA from its initial discovery to its modern-day significance. Including early anatomical studies and a detailed examination of contemporary surgical practices, as preoperative imaging through Magnetic Resonance Angiography (MRA) and Computed Tomography Angiography (CTA). Clinical outcomes from neuroprotective approaches were analyzed to assess effectiveness in reducing spinal cord ischemia.

Results: Historically, a lack of understanding regarding the AoA’s anatomical variability contributed to frequent spinal cord injuries, particularly during spinal surgeries and aortic aneurysm repairs. Today, advances in imaging techniques, such as MRA and CTA, allow for the precise identification of the AoA, significantly improving surgical planning and patient safety. Neuroprotective strategies has further reduced the incidence of postoperative paraplegia, showing a marked improvement in outcomes during TAAA repairs. These advancements illustrate the lasting impact of Adamkiewicz’s discovery on the field of neurosurgery.

Conclusion : The discovery of the Artery of Adamkiewicz represents a turning point in both spinal and vascular surgery, where a deepened understanding of this critical artery has translated into better patient outcomes. Modern technologies have built upon this historical foundation, ensuring the AoA’s protection during high-risk procedures and reducing the risk of devastating neurological complications. The legacy of Adamkiewicz’s work continues to shape surgical practices today, offering both historical significance and ongoing clinical relevance.