Variations of the Iliolumbar and Ascending Lumbar Veins

Kunakornsawat, Sombat; Prasartritha, Thavat; Korbsook, Patipan; Vannaprasert, Nuttapon; Tungsiripat, Rachata; Tansatit, Tanvaa

doi:10.1097/bsd.0b013e31823c0fa0

Cited by 8 publications

(3 citation statements)

References 15 publications

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“…Similar to previous studies, the present study showed that the ILVs drain into the CIV, EIV, and IIV [ 1 , 12 , 24 ]. However, the CIV has been reported as the sole terminal drainage site for the ILVs with varying frequencies ( Table 3 ) [ 8 , 14 , 17 , 18 ].…”

Section: Discussionsupporting

confidence: 90%

Topography and Composition of the Iliolumbar Veins in a South African Cohort: Implications for Spinal Surgery

2023

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A descriptive cross-sectional study of the anatomical variations, morphometry, and histology of the iliolumbar veins (ILVs).Purpose: This study aimed to describe the anatomical variations of the ILVs and determine their tissue composition in South African cadavers of European descent. Overview of Literature: A safe anterior surgical approach to the L4/L5 intervertebral disc space requires understanding the anatomy of the ILVs. Limited understanding of ILVs and their variations may lead to inadvertent avulsion of veins with subsequent hemorrhage and damage to the adjacent nerves intraoperatively. Variations in ILVs are population specific, but such reports are limited in the South African population. Methods: Eighty-nine adult cadavers were dissected to reveal ILV patterns. The variations (origin, course, and drainage pattern), morphometries, and topography of the ILVs were studied. A total of 19 (10 proximal, nine distal) ILVs were processed for hematoxylin and eosin, Masson's trichrome, and Verhoeff's histological staining to determine the tissue composition. Results: The ILVs were identified in 100% of the cases, and 45% of the ILVs were anastomosed to each other bilaterally. The rightside ILVs terminated into the posterior surfaces of the iliac vessels (p=0.001), whereas the left-side ILVs terminated into the lateral surfaces (p=0.001). The left-side proximal ILVs had higher elastic fiber composition (p=0.030). The ratio of the ILVs' elastic fibers to collagen fibers was 1:9, and 61% of the cadavers exhibited type 1 ILV pattern. Moreover, 42% of the ILVs were at the S1 vertebral level with 31% lying between L4 and L5 spinal nerve roots. The obturator nerve coursed anteriorly to the ILVs in 96% of cases. Conclusions: The ILV variations described for South Africans present new additional patterns, such as bilateral anastomosis and laterality of the terminal drainage. The ILVs have more collagen fibers than elastic fibers, predisposing them to avulsion during surgical retraction. The identification of all the ILVs is crucial to minimize inadvertent hemorrhage and damage to adjacent structures.

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Section: Discussionsupporting

confidence: 90%

Topography and Composition of the Iliolumbar Veins in a South African Cohort: Implications for Spinal Surgery

2023

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confidence: 99%

“…When these stents are placed in the iliac system, they can migrate up through this venous tract directly into the spinal canal, which is the supposed method of injury in these previously reported cases. 6,7 We report the case of a patient presenting to our institution with intraspinal misplacement of an endovenous stent, resulting in cauda equina syndrome, and who was managed surgically. This rare clinical presentation has been sparsely reported in the literature.…”

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Misplaced intraspinal venous stent causing cauda equina syndrome: illustrative case

Shah,

Johnstone,

Haider

et al. 2024

Journal of Neurosurgery: Case Lessons

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BACKGROUND Endovenous stents for deep venous thrombosis treatment can be unintentionally placed in the spinal canal, resulting in neurological deficit. OBSERVATIONS The authors report the case of a patient presenting to our institution with intraspinal misplacement of an endovenous stent, resulting in cauda equina syndrome. The authors also performed a systematic literature review, evaluating the few previously reported cases. This review was performed according to the updated Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. In four of five cases describing stent misplacement into the spinal canal, the authors report that only anteroposterior monoplanar imaging modalities were utilized for venous localization and stent deployment. The anteroposterior plane cannot assess the relative depth of structures, nor can it distinguish between superimposed structures well. Therefore, the use of biplanar imaging should at least be considered before stent deployment, as intraspinal stent placement can lead to disastrous consequences. LESSONS This report should serve as an impetus for the use of biplanar or three-dimensional imaging modalities for iliac venous stent placement. Additionally, this work should increase spine surgeons’ awareness about management and operative techniques when faced with this complication.

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A novel surgical approach using the “lateral corridor” for minimally invasive oblique lumbar interbody fusion at L5-S1: a clinical series and technical note

Jang,

Lee,

Choi

et al. 2024

Eur Spine J

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Variations of the Iliolumbar and Ascending Lumbar Veins

Cited by 8 publications

References 15 publications

Topography and Composition of the Iliolumbar Veins in a South African Cohort: Implications for Spinal Surgery

Topography and Composition of the Iliolumbar Veins in a South African Cohort: Implications for Spinal Surgery

Misplaced intraspinal venous stent causing cauda equina syndrome: illustrative case

A novel surgical approach using the “lateral corridor” for minimally invasive oblique lumbar interbody fusion at L5-S1: a clinical series and technical note

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