Revisiting intrathecal dorsal venous patterns of the spinal cord at thoracolumbar level as probable factor for post lumbar puncture spinal hematoma
| Autor: | Arunkumar Arivalagan, Gugapriya Ts |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
musculoskeletal diseases
medicine.diagnostic_test business.industry Lumbar puncture Meninges Thoracolumbar Region Anatomy musculoskeletal system Intrathecal Spinal cord Standard anatomical position medicine.anatomical_structure Cadaver cardiovascular system Foramen Medicine Surgery Neurology (clinical) business |
| Zdroj: | Turkish Neurosurgery. |
| ISSN: | 1019-5149 |
| Popis: | AIM The spinal cord is drained by three interconnected venous systems. Among them the extrinsic venous system of the dorsal thoracolumbar region with its radicular communications is liable to get injured due to its anatomical position. With increasing case reports of post puncture hematomas, revisiting the intrathecal extrinsic venous system of spinal cord has become a necessity. MATERIAL AND METHODS In a tertiary teaching institution, 25 adult cadavers were dissected by standard dissection procedure and spinal cord was removed with meninges. The dorsal aspect was further dissected out and layers of meninges were removed carefully to expose the extrinsic venous system in the dorsal region. The specimens that showed engorged veins were further studied for their extent, pattern, presence of radicular veins, their level and route of exit. RESULTS Five specimens showed variant dorsal venous pattern of the extrinsic system of veins in the thoracolumbar region. The main dorsal spinal vein was seen to be engorged, tortuous and more than 2mm with engorged radicular veins. Out of 8 engorged radicular veins observed, 6 exited through the dorsal nerve root foramen and 2 exited through a separate foramen. CONCLUSION The variant anatomy of intrathecal extrinsic venous system with engorgement of the thoracolumbar region veins might get injured during lumbar puncture procedure. The exit of radicular veins and the dorsal nerve root through the same foramen also makes the veins susceptible to post procedural spinal hematomas. |
| Databáze: | OpenAIRE |
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