Observations on the Venous Drainage of the Human

There has been an upsurge of interest in dynamic studies of the spinal circulation during the past ten years, with the clinical applications of selective intercostal angiography and intraosseous vertebral phlebography (Doppman, Di Chiro and Ommaya 1969 ; Houdart, Djindjian and Hurth 1969; Vogelsang 1970). In clinical practice these investigations have been used to depict mechanical obstructions in the vascular systems or angiomatous malformations. Over the same period there has been a shift of emphasis from the long established view that disorders of the intervertebral discs result purely from mechanical derangements (Nachemson 1969, Crock 1970). It is becoming evident that the intervertebral disc should be viewed more as a dynamic organ in which the homeostatic and pathological processes are intimately linked with its nutritional systems. We have been struck, therefore, by the necessity for more detailed studies on the anatomy of spinal circulation. To our knowledge there are no comprehensive works on the intraosseous vessels of the vertebral column with particular reference to the venous side of the circulation in the subchondral zones of the vertebral bodies, adjacent to the intervertebral discs. In this paper we wish to present some of our findings on the anatomy of the intraosseous veins of the vertebral bodies together with new observations on the subchondral venous plexus adjacent to the intervertebral disc. This material has been selected for preliminary publication from more than 100 human spinal columns in which either arteries or veins had been injected after death, in the course of a wider study of the blood supply of the vertebral column and spinal cord.