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Figure 1.16. The venous drainage of the spinal cord. (1) The dorsal root, (2) the ventral nerve root, (3 and 10) the coronal venous plexus (radial veins), (4) the anterior median vein of the ventral longitudinal venous system, (5) a dorsal longitudinal vein, (6) a transmedullary anastomotic vein, (7) a dorsal sul-cal vein, (8) a radiculomedullary vein, (9) a ventral longitudinal vein.

unidirectional; rather, it depends upon the location of the outflow vein at each anatomic level.

The ventral epidural venous plexus drains into multiple different outflow veins, depending upon the anatomical level. These are as follows.

1. Cervical. Drainage is into the vertebral veins, which in turn empty into the innominate veins.

2. Thoracic. Drainage is into the intercostal veins, which then empty into the azygous and hemiazygous systems and subsequently the inferior vena cava.

3. Lumbar. Drainage is multiple, involving the ascending lumbar vein (on the left), the azygous and hemiazygous systems, and the left renal vein. The final common pathway is generally the inferior vena cava.

4. Sacral. Drainage is into sacral veins, emptying into the lateral sacral veins, and subsequently the internal iliac veins.

References

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13. Bromage PR: Anatomy of the epidural space. In: Bromage PR, ed; Epidural Analgesia. Philadelphia: WB Saunders; 1978:8-20.

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