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Internal Vertebral Venous Plexus

plexus venosus vertebralis internus

The internal vertebral venous plexus (Batson's plexus) consists of two anterior and two posterior longitudinal veins running within the spinal canal, connected by transverse anastomoses and communicating freely with the basivertebral veins, the intervertebral veins, and the external vertebral plexus. Being valveless, it allows bidirectional flow under varying abdominal pressures.

Region: Lower Back

Clinical Relevance

Clinical Notes

Batson's plexus is the route by which prostate, breast, lung, and thyroid cancers metastasise to the spine, bypassing the systemic venous circulation. During Valsalva manoeuvre, increased abdominal pressure reverses flow through the plexus, explaining why straining activities worsen disc herniation pain. The plexus is the source of epidural haematoma in anticoagulated patients. It is the primary venous route when the inferior vena cava is obstructed.

Pathology

Common Injuries & Conditions

Epidural Haematoma

Bleeding from the internal vertebral venous plexus in the epidural space from anticoagulation, trauma, or spontaneous rupture, producing acute cord compression requiring emergency surgical decompression.