Vertebral Venous Collaterals with underlying Agenesis of the Inferior Vena Cava: Implications for Spinal Surgery.

Vertebral Venous Collaterals with underlying Agenesis of the Inferior Vena Cava: Implications for Spinal Surgery.

World Neurosurg. 2018 Mar 12;:

Authors: Yoon JW, Ganaha S, Watridge C

Abstract
BACKGROUND: Congenital agenesis of the inferior vena cava (IVC) can lead to the development of a prominent venous collateral system within and around the spine due to the development of venous collaterals. Surgery on such patients can harbor the risk of catastrophic bleeding or decompensation of a delicate venous drainage pattern during spinal manipulation or even epidural exploration.
CASE DESCRIPTION: A 49-year old man with a congenital agenesis of the IVC presented with signs and symptoms of an L5 radiculopathy. Computerized tomography of the lumbar spine showed the characteristic finding of fenestrated or "holey" pedicles within the lumbar spine, which was due to chronic venous engorgement within the pedicles.
CONCLUSION: To our knowledge, this is the first report to describe the characteristic sign of "holey pedicles" on radiographic imaging in a patient with an underdeveloped IVC. This finding may be useful to detect abnormal spinal venous anatomy. Spinal surgery for such patients may be of greater risk and requires special consideration. .

PMID: 29545223 [PubMed - as supplied by publisher]

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