Transosseous Vertebral Venography: A Diagnostic Aid in Lumbosacral Disease

Abstract

Transosseous vertebral venography as a technic for investigating disease of the lumbosacral region is described. The technic preferred by the author is an intraosseous injection of contrast medium into the body of L7. Using a caudal needle, 10 ml of contrast medium was injected manually and a radiograph was made as the last milliliter was introduced. Contrast medium filled the lumbar venous sinuses and, by reflux, filled the sacral sinuses caudally to the S2–3 intervertebral foramen. Lumbosacral disease caused an obstruction to contrast medium flow and narrowed or deviated the vertebral venous sinus. Complications of transosseous vertebral venography were extravasation of contrast medium into the epidural space and surrounding soft tissue, and trauma to the sixth lumbar nerve in one dog. The procedure was contraindicated in the presence of local infection and when anesthesia was an undue risk.

Magnetic Resonance Imaging of the Caudal Lumbar and Lumbosacral Spine in 13 Dogs (1990–1993)

“…Both medium and low signal irregular proliferation associated with the ventral and lateral aspects of the vertebral bodies (Figs. 5,6,9) were present in all but 3 dogs (#2, 9,12). This material was presumed to represent spondylosis deformans which was identified on survey radiographs of the spine in all dogs where this proliferation was seen with the exception of dog #4 where minimal proliferation was identified on MRI study.…”

“…Intervertebral disc degeneration was observed in all but 2 dogs (#2, 8). Numbers of degenerate discs ranged from none (#2, 8) to single at L,-S, ( # 5 , 6 , 7,9,12), to multiple (# 1, 10, 11). Determination could not be made in two dogs (#4, 13) since only T1 images were obtained ( # 13) or T2* images were made only in the axial plane at the site of previous laminectomy (#4).…”

“…Intervertebral disc protrusion or the presence of a medium signal intense mass within the vertebral canal or intervertebral foramen was identified in all but 2 dogs (#2, 8). Four dogs ( # 5 , 6,9,12) had single disc protrusions involving L7-S 1. Two dogs evaluated postoperatively (#3, 4) had medium signal masses within the ventral vertebral canal.…”

“…All dogs were evaluated with survey radiographs of the caudal lumbar and lumbosacral spine. In addition, 4 dogs were also studied with an epidurogram (#1) and myelograms (#7, 12,13).…”

Effects of artificially induced spinal cord compression on the canine cervical internal vertebral venous plexus: comparative evaluation of computed tomographic venography and digital subtraction venography

“…Previous studies in monkeys, using conventional venography and a similar balloon compression model in the lumbar region, also demonstrated total obstruction of the IVVP during balloon inflation (Doppman 1976). Intraosseous and catheter epidural venography in human beings and dogs have been reported to display unilateral or bilateral block of the IVVP at the site of disk herniation (LePage 1974, Theron 1976, Miyasaka et al 1978, Blevins 1980. Venographic studies in human beings have also demonstrated that, in cases of cervical disk disease, interruption of the IVVP usually occurs at multiple vertebral levels (Miyasaka et al 1978).…”