• Andrew A Fanous, Lindsay J Lipinski, Chandan Krishna, Eric P Roger, Adnan H Siddiqui, Elad I Levy, Jody Leonardo, and John Pollina.
• *Department of Neurosurgery, School of Medicine & Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, New York, NY †Department of Neurosurgery, Buffalo General Medical Center/Kaleida Health, Buffalo, New York, NY ‡Department of Radiology, School of Medicine & Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, New York, NY §Toshiba Stroke and Vascular Research Center, University at Buffalo, The State University of New York, Buffalo, New York, NY; and ¶Jacobs Institute, Buffalo, New York, NY.
• Spine. 2015 Aug 1; 40 (15): 1194-9.

Study DesignRetrospective study.ObjectiveTo investigate the impact of spinal angiography on selection of surgical side in patients undergoing thoracolumbar corpectomy.Summary Of Background DataThe artery of Adamkiewicz provides the major blood supply to the thoracolumbar spinal cord. Its location makes it vulnerable to injury during surgical procedures. Preoperative diagnostic spinal angiography is often used to determine the level and lateralization of the artery.MethodsData were gathered regarding level and laterality of the Adamkiewicz artery in 34 patients who underwent lateral extracavitary approaches to the thoracolumbar spine, preceded by diagnostic spinal angiography for localization of that artery. Two experienced spine surgeons were retrospectively polled regarding ideal side of approach for each case. This was compared with the actual side that was selected after angiographic localization.ResultsThe artery was successfully identified in 71% of patients. The artery was most commonly located on the left side (83%) between T9 and L1 (83%). Diagnostic angiography seemed to have influenced surgical decision making in 54% of cases. In 21% of patients, there was no need to alter the side of approach. In the remaining 25%, the surgical plan was not altered on the basis of angiographic data, presumably due to anatomic limitations. No angiography- or surgery-related complications occurred in any of the patients.ConclusionPreoperative spinal angiography seems to impact surgical decision making with regard to alteration of the side of approach in patients undergoing thoracolumbar corpectomy via lateral extracavitary approaches.Level Of Evidence4.

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