Vertebral Vein

vena vertebralis

The vertebral vein descends in the transverse foramina of the cervical vertebrae alongside the vertebral artery, draining the deep cervical muscles, the suboccipital region, and communicating with the vertebral venous plexus within the spinal canal. It exits below C6 and drains into the brachiocephalic vein. It connects the intracranial venous sinuses with the epidural venous plexus and the azygos system.

Region: Neck

Clinical Relevance

Clinical Notes

The vertebral vein is relevant in cervical spine surgery, particularly during the lateral approach to the cervical vertebral bodies and in C1-C2 transarticular screw placement where the vertebral artery and vein in the transverse foramen may be encountered. Its communication with the vertebral venous plexus (Batson's plexus) within the spinal canal creates a valveless pathway for haematogenous spread of infection and tumour from the pelvis and abdomen to the cervical and thoracic spine. Vertebral vein injury during posterior cervical approaches produces significant bleeding from the valveless plexus.

Pathology

Common Injuries & Conditions

Vertebral Vein Injury in Cervical Spine Surgery

Lateral approach exposure of the cervical vertebral bodies and pedicle screw placement risk the vertebral vein in the transverse foramen medial to the vertebral artery; vertebral vein injury produces venous haemorrhage from the valveless epidural venous plexus connections that is controlled by bipolar coagulation, haemostatic agents, and pressure packing.