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Posterior Internal Vertebral Venous Plexus

plexus venosus vertebralis internus posterior

The posterior internal vertebral venous plexus consists of two longitudinal channels running in the epidural space posterior to the dura, connected by transverse anastomoses across the midline and by communicating vessels to the anterior internal vertebral plexus. It receives blood from the vertebral laminae, ligamentum flavum, and spinal cord.

Region: Lower Back

Clinical Relevance

Clinical Notes

The posterior internal vertebral venous plexus is the source of epidural haematoma after posterior spinal surgery, especially in patients on anticoagulation. Its vessels bleed freely when the ligamentum flavum is incised, requiring bipolar haemostasis before dural entry. The plexus engorgement in pregnancy, IVC obstruction, and portal hypertension makes posterior spinal approaches technically more demanding and haemorrhagic.

Pathology

Common Injuries & Conditions

Posterior Epidural Haematoma

Haemorrhage from the posterior internal vertebral plexus into the posterior epidural space after spinal surgery or spontaneously in anticoagulated patients, producing acute spinal cord compression requiring emergency decompression.