Cervical vertebral phlebography.

Abstract

The main features of the anatomy of the veins of the vertebral canal have long been known as a result of dissection studies. The first roentgenographic examinations of the epidural veins were carried out in 1952 by FISCHGOLD et coll., who injected a water-soluble contrast medium into the spinous process of a lower thoracic vertebra and succeeded in demonstrating these vessels in the thoracic and lumbar parts of the vertebral canal; SCHOBINGER described the roentgenologic appearances of these veins in more detail. HELANDER & LINDBOM, in an attempt to demonstrate changes in the epidural veins in connection with disk protrusions in the lumbar vertebral region, compressed the inferior vena cava and injected contrast medium into that vein. SCHOBINGER endeavoured to outline the epidural veins in the cervical vertebral region by injecting contrast medium into the spinous process of the second cervical vertebra; he was only partially successful, however, and even when the veins were visible they were poorly outlined. He summed up his results as follows: ‘Since injection of contrast medium into the spinous processes of the cervical vertebrae fails to outline well the internal vertebral venous plexus in the cervical region it presently can be assumed that this method is inadequate for the routine diagnosis of protruded cervical discs’. Anatomical investigations have shown that the red marrow in the bodies of the vertebrae contains several venous channels - the basivertebral veins which.unite in the cervical vertebral region into two stems running in an