Anatomical study of the thoracolumbar radiculomedullary arteries, including the Adamkiewicz artery and supporting radiculomedullary arteries

OBJECTIVE The aim of this paper was to identify and characterize all the segmental radiculomedullary arteries (RMAs) that supply the thoracic and lumbar spinal cord. METHODS All RMAs from T4 to L5 were studied systematically in 25 cadaveric specimens. The RMA with the greatest diameter in each specimen was termed the artery of Adamkiewicz (AKA). Other supporting RMAs were also identified and characterized. RESULTS A total of 27 AKAs were found in 25 specimens. Twenty-two AKAs (81%) originated from a left thoracic or a left lumbar radicular branch, and 5 (19%) arose from the right. Two specimens (8%) had two AKAs each: one specimen with two AKAs on the left side and the other specimen with one AKA on each side. Eight cadaveric specimens (32%) had 10 additional RMAs; among those, a single additional RMA was found in 6 specimens (75%), and 2 additional RMAs were found in each of the remaining 2 specimens (25%). Of those specimens with a single additional RMA, the supporting RMA was ipsilateral to the AKA in 5 specimens (83%) and contralateral in only 1 specimen (17%). The specimens containing 2 additional RMAs were all (100%) ipsilateral to their respective AKAs. CONCLUSIONS The segmental RMAs supplying the thoracic and lumbar spinal cord can be unilateral, bilateral, or multiple. Multiple AKAs or additional RMAs supplying a single anterior spinal artery are common and should be considered when dealing with the spinal cord at the thoracolumbar level

A history of Colombian neurosurgery : events, persons, and outcomes that have shaped the specialty in the country

Q1Q1The history of Colombian neurosurgery is a collective legacy of neurosurgeon-scientists, scholars, teachers, innovators, and researchers. Anchored in the country’s foundational values of self-determination and adaptability, these pioneers emerged from the Spanish colonial medical tradition and forged surgical alliances abroad. From the time of Colombian independence until the end of World War I, exchanges with the French medical tradition produced an emphasis on anatomical and systematic approaches to the emerging field of neurosurgery. The onset of American neurosurgical expertise in the 1930s led to a new period of exchange, wherein technological innovations were added to the Colombian neurosurgical repertoire. This diversity of influences culminated in the 1950s with the establishment of Colombia’s first in-country neurosurgery residency program. A select group of avant-garde neurosurgeons from this period expanded the domestic opportunities for patients and practitioners alike. Today, the system counts 10 recognized neurosurgery residency programs and over 500 neurosurgeons within Colombia. Although the successes of specific individuals and innovations were considered, the primary purpose of this historical survey was to glean relevant lessons from the past that can inform present challenges, inspire new opportunities, and identify professional and societal goals for the future of neurosurgical practice and specialization.https://orcid.org/0000-0001-9087-1392Revista Internacional - IndexadaA1N

Pulmonary involvement in sjögren's syndrome

El síndrome de Sjögren es una enfermedad autoinmunitaria sistémica con un alto impactoindividual y social. El compromiso pulmonar presenta múltiples manifestaciones, conimpacto en calidad de vida y riesgo de mortalidad. El abordaje dinámico integrado medianteun grupo de diagnóstico multidisciplinario que incluya expertos en neumología, reumatolo-gía, radiología y patología tiene el potencial de impactar en la identificación, las estrategiasde manejo y los desenlaces. Aunque es necesario reconocer tempranamente a los pacientescon mayor riesgo, en la actualidad no se cuenta con biomarcadores confiables. Las estrate-gias de manejo farmacológico se basan en la inmunomodulación, pero la evidencia para suuso es de baja calidad. Promover el entrenamiento y la sensibilización del personal de saludpodría reducir los retrasos en el acceso a una evaluación especializadaQ4Sjögren's syndrome is a systemic autoimmune disease with a high burden for the individual, as well as society. Pulmonary compromise presents with a myriad of manifestations that influence patient quality of life and mortality risk. An integrated dynamic approach by a multidisciplinary diagnostic discussion team that includes experts in chest diseases, rheumatology, radiology, and pathology has the potential to improve the identification, management strategies, and outcomes. Although early recognition of patients at high risk is essential, there is currently a lack of reliable biomarkers. Pharmacological therapies are based on immunomodulation, although the evidence to support their use is of low quality. Increasing awareness and training among healthcare professionals may reduce a delayed access to specialized assessment.https://orcid.org/0000-0002-8244-2958https://orcid.org/0000-0002-6925-3570https://orcid.org/0000-0001-9850-9101https://orcid.org/0000-0001-6461-2725https://orcid.org/0000-0002-8549-661Xhttps://orcid.org/0000-0001-6034-0005https://orcid.org/0000-0002-0084-0339https://orcid.org/0000-0003-1490-1822https://orcid.org/0000-0001-8405-4513N/