Resumo:

ABSTRACT

Endoscopic spine surgery has become increasingly popular among specialized surgeons, driven by its minimally invasive approach and increasing clinical versatility. Initially restricted to the lumbar spine, its indications have expanded to the cervical region and, to a lesser extent, the thoracic region, offering a less aggressive and more affordable alternative to traditional procedures such as laminectomy, costotransversectomy, and the anterior extracavitary approach to the thoracic spine. During interventions in this segment, it is common to identify segmental vessels, whose anatomical position may vary depending on the surgical level. In certain cases, the segmental artery and vein overlap or invade the disc space, becoming critical structures to consider during endoscopic decompression. This study’s primary objective was to highlight the relevance of Adamkiewicz’s artery in endoscopic spinal surgery. To this end, a narrative review was conducted according to the PRISMA method guidelines, structured according to the PICOS criteria: adults, as defined by the World Health Organization (Population); endoscopic procedures involving the artery of Adamkiewicz (Intervention); surgical techniques that do not consider this vascular structure (Comparison); and clinical trials and case studies (Outcome). The analysis culminated in the selection of 20 articles, which supported the discussion and the findings presented. It is concluded that accurate identification of the artery of Adamkiewicz is essential for preventing neurological complications, and its preservation is a determining factor in reducing the risk of spinal cord ischemia during spinal procedures. Advanced imaging techniques, such as magnetic resonance angiography, have demonstrated high efficacy in locating this vessel, allowing surgeons to plan minimally invasive approaches with greater precision and safety.

Resumen: