Transfemoral Ascending Lumbar Catheterization of the Epidural Veins in Lumbar Disk Disease

Vertebral Venography in Disc Disorders

“…He found it an easy, accurate investigation, with low morbidity, and it could be repeated without distress if necessary. Gargano et al (1974) listed the radiographic signs of lumbar disc herniation using venography, and noted that in any one individual the epidural veins were symmetrical. They felt that only anteroposterior views were normally necessary, but the lateral view was sometimes useful to demonstrate posterior displacement of an epidural vein.…”

“…In looking at alternative procedures, we felt that the reports of vertebral venography appearing in Continental and American journals suggested that the technique had some promise (Bucheler & Janson 1973, Lepage 1974, Gargano et al 1974 The Vertebral Venous System Medieval authors, such as Vesalius, described the anatomy of this system. In more recent times, Batson has carried out much research into its structure and function in life (Batson 1940, Batson 1957); he has shown that this is a 'system' of veins, separate and, except in the sense that they carry blood, different from the veins of the extremities and the body cavities.…”

“…The vertebral bodies are richly endowed with these sinuses, and the veins readily fill, but this procedure really requires an anesthetic, and details may be obscured by extravasation shadows in the vertebral body. More recently, improvements in intravascular catheterization techniques enabled several workers (Bucheler & Janson 1973, Gargano et al 1974, Lepage 1974) to fill the vertebral veins by femoral puncture and catheterization of the ascending lumbar vein; this is the technique used in this study. Under local anesthesia, the left (usually) femoral vein is cannulated and a catheter guided, via the iliac vein, into the ascending lumbar vein, under visual screening.…”

Lumbo‐sacral Vertebral Sinus Venography via Transjugular Catheterization in the Dog

“…Furthermore, both of these procedures bring potentially irritating substances into contact with sensitive spinal m e n i n g e~.~.~ Evaluation of L-S spinal canal and cauda equina lesions by vertebral sinus venography (VSV) has been advocated in man6-14 and dogs .2,15-17 Intervertebral disc herniation, traumatic and degenerative L-S instability and malarticulation, L-S spinal canal stenosis, thickening of the ligamentum flavum, discospondylitis, and traumatic or neoplastic spinal vein embolization have been demonstrated using this technic .2,15-20 Several studies comparing the value of VSV versus myelography in diagnosis of caudal lumbar o r L-S disc herniations in man have documented the superiority of VSV.7,9JoJ4,21, 22 VSV has the following advantages: (1) tebral sinuses (VS) are well defined, anatomic structures which lie adjacent to the spinal cord and cauda equina in close contact with the dorsal longitudinal ligament throughout the L-S region , L , 9 3 2 3 and (2) contrast medium injected into the VS is restricted to contact with the intravascular Disadvantages include relative procedural complexity, inconsistent filling of the VS, and difficulties in the interpretation of the plexiform arrangement of the T h e technic of VSV by intraosseous injection of contrast medium has been described in humans .6326327 In recent years the intraosseous technic has, to a large extent, been replaced by selective and superselective catheter v e n~g r a p h y .~-'~, '~, '~ Ad vantages of catheterization are ease of performance, more consistent visualization of the VS, and fewer postprocedural complications . [7][8][9]12,13 Based on the successful use of VSV in humans, several investigators have adapted the intraosseous technic for use in the…”