亚当基维奇动脉（AKA）对脊髓血液供应至关重要。它在骨转移栓塞过程中的作用可能导致严重的并发症。我们研究了骨转移病人中AKA的患病率、解剖变异及对脊柱栓塞的影响。为了理解AKA在骨转移病例中的脊柱栓塞治疗中的影响及变异，以减少并发症并改善患者预后。我们研究了2009年至2018年间接受NBCA脊柱栓塞治疗的454例患者的数据。通过术前影像学和血管造影评估了AKA的存在、吻合情况和肿瘤特征。并按照CIRSE分类系统对并发症进行分类。22.8%的患者发现了AKA，以左侧为主，起源于T8到L1之间。直接吻合和间接吻合分别出现在66.6%的患者和33.4%的患者中。与直接吻合（P = 0.004）相关的是肾脏肿瘤的外区侵袭。高级别并发症较少，但包括一例双下肢瘫痪。由于AKA的存在，22.8%的病例需要部分栓塞治疗。本研究强调了在接受骨转移病人进行脊柱栓塞治疗前需要进行严格的AKA起源和吻合的术前评估。考虑到AKA及其相关吻合的显著存在，尤其是与肾脏外区肿瘤相关的吻合，建议谨慎操作以减少并发症并优化患者预后。进一步的研究还需要制定骨转移和AKA最佳操作指南。

The artery of Adamkiewicz (AKA) is vital for spinal cord blood supply. Its role in embolization procedures for bone metastases can cause serious complications. We explored its prevalence, anatomical variation, and effect on spinal embolization using N-butyl cyanoacrylate (NBCA) in patients with bone metastases.To understand the impact and variability of AKA in spinal embolizations in cases of bone metastases to reduce complications and improve patient outcomes.We examined data from 454 patients who underwent spinal embolization with NBCA between 2009 and 2018. The presence, anastomoses, and tumor features of AKA were assessed via pre-procedure imaging and angiography. Complications were classified per the CIRSE Classification System.AKA was found in 22.8% of patients, predominantly left-sided and originating from T8 to L1. Direct and indirect anastomoses were present in 66.6% and 33.4% of patients, respectively. Extra-compartmental invasion was linked with direct anastomosis (P = 0.004). High-grade complications were rare but included one instance of bilateral lower limb paralysis. Partial embolization was necessary in 22.8% of cases due to AKA.The study underscores the need for rigorous preoperative evaluation of AKA origin and anastomoses in patients undergoing spinal embolization for bone metastases. Given the significant presence of AKA and related anastomoses, especially with renal extra-compartmental tumors, caution is advised to reduce complications and optimize patient outcomes. Further research is required for best practice guidelines involving bone metastases and AKA.