The vertebral column is important for protecting the spinal cord, as well as providing structural support, flexibility, and range of motion to our bodies. To maintain all of these important functions, our vertebral column requires an adequate blood supply and innervation.

Alright, let’s start with the arteries of the vertebrae, which arise from various larger, parent arteries depending on the level of the vertebral column.

In the neck, parent arteries include the vertebral and ascending cervical arteries; In the thorax, the posterior intercostal arteries;

In the abdomen, they include the subcostal and lumbar arteries. And finally, in the pelvis, parent arteries include the iliolumbar, lateral sacral, and median sacral arteries.

Now, as these parent arteries cross the external surfaces of the vertebrae, they give rise to periosteal, equatorial, and spinal branches that directly supply the vertebrae.

Periosteal branches supply the periosteum, which is a dense layer of connective tissue that surrounds the vertebrae. The equatorial branches supply the vertebral bodies themselves.

Spinal branches pass through the intervertebral foramina and divide into smaller anterior and posterior vertebral canal branches.

Anterior vertebral canal branches follow the surface of the vertebral body anteriorly within the vertebral canal. Here, these arteries send nutrient branches that supply the red marrow of the vertebral body.

Posterior vertebral canal branches follow the vertebral arch posteriorly within the vertebral canal. These branches terminate as radicular arteries that supply the nerve roots, and segmental medullary arteries that supply the spinal cord.

Finally, both of these branches give rise to ascending,and descending branches that anastomose with spinal canal branches of adjacent levels.

Venous blood drains from the vertebral column through spinal, basivertebral, and intervertebral veins.

Let’s start with spinal veins, which form plexuses along the vertebral column. These plexuses include the internal vertebral or epidural venous plexuses, which lie inside the vertebral canal, or the external vertebral venous plexuses, outside the vertebral canal. These plexuses communicate through the intervertebral foramina.