Transparent Internal Vertebral Venous Plexus

Description

Running longitudinally within the vertebral canal, the internal vertebral venous plexus forms a paired, transparent lattice in the epidural space between the dura mater and the periosteum of the vertebral arches and posterior vertebral bodies. Anterior and posterior internal vertebral veins track superior to inferior and communicate across the midline, hugging the posterior longitudinal ligament anteriorly and approaching the ligamenta flava posteriorly. Segmental connections extend laterally toward the intervertebral foramina, where they join the external vertebral venous plexus and regional veins. No valves. That valveless architecture is the point. Because flow can reverse with changes in intraabdominal or intrathoracic pressure, Batson’s plexus provides a recognized pathway for hematogenous spread of metastases to the spine, classically from prostate carcinoma in men, and it also influences patterns of epidural infection and venous engorgement. Surgeons operating in the spinal canal meet it early, since the plexus can bleed briskly during laminectomy, discectomy, or pedicle screw placement, and it can become prominent with portal hypertension or inferior vena cava obstruction. Use this illustration for teaching vertebral canal contents in gross anatomy and neuroradiology modules, for oncology texts discussing vertebral metastasis routes, or for spine surgery references that address epidural venous bleeding control and safe corridor planning around the epidural space. Anatomical accuracy verified by SciePro's Medical Advisory Board.