Spinal Cord and Spine Veins

Anterior view of an angiogram of the spinal venous network, showing thre three levels of spinal venous drainage: sacral, lumbar, and thoracic. The iliac veins are partially opacified as is the inferior vena cava. The ascending lumbar veins are not totally opacified. The ascending flow of contrast is through the epidural plexus. The suprapedicular and infrapedicular veins are visible throughout the length of the spine. The azygos vein is also identified.

Lateral view of the epidural angiogram showing the anterior internal vertebral venous plexus and very faintly the posterior internal and external venous flexus. The inferior vena cava is only partially visualized due to the pathologic narrowing. The azygos vein is also depicted from its origin. Note the communication of the iliac venous system with the perivertebral venous plexus through the sacral veins, explaining the role of the vertebral veins in the spread of metastases, accordingly to Batson.

Axial view of the vertebrae showing the intimate relationship of the anterior internal venous plexus to the posterior aspect of the vertebrae. Four vertical channels are seen end-on connected by the lateral transverse branches.