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Lumbar Veins

venae lumbales

The four pairs of lumbar veins drain the posterior abdominal wall, paraspinal muscles, and the lumbar vertebral column, draining into the ascending lumbar veins and thence into the azygos system on the right and hemiazygos on the left, with direct drainage into the inferior vena cava for L1-L3. The ascending lumbar veins connect all four lumbar veins vertically, forming a collateral pathway between the iliac and caval systems.

Region: Lower Back

Clinical Relevance

Clinical Notes

Lumbar vein injury during aortic aneurysm repair, retroperitoneal dissection, and anterior lumbar spine surgery causes difficult-to-control haemorrhage because the veins retract into the paravertebral musculature. The third and fourth lumbar veins are at particular risk during retroperitoneal lymph node dissection and left-sided aortic exposure. The ascending lumbar vein provides collateral venous drainage when the IVC is occluded or ligated, and its identification prevents accidental division during IVC reconstruction.

Pathology

Common Injuries & Conditions

Lumbar Vein Avulsion in ALIF

Anterior lumbar interbody fusion requires retraction of the great vessels off the vertebral bodies, placing lumbar veins at risk of avulsion from the IVC or aorta, causing brisk haemorrhage in the retroperitoneal space that may require conversion to open surgery for vascular control.