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Updated: Jun 4, 2026
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Three-Dimensional Imaging of the Vertebral Lymphatic Vasculature and Drainage using iDISCO+ and Light Sheet Fluorescence Microscopy
Published on: May 22, 2020
Lymphatic involvement in vertebral and disc pathology.
Takeshi G Kashima1, Arundhati Dongre, Nicholas A Athanasou
1Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Science, University of Oxford, Nuffield Orthopaedic Centre, Oxford OX3 7LD, England.
Spine
|February 24, 2011
Summary
Lymphatic vessels are absent in normal adult and child spinal vertebrae and intervertebral discs. However, lymphatics appear in pathological spinal conditions, suggesting they do not facilitate spinal tumor metastasis.
Area of Science:
- Spinal Anatomy and Pathology
- Lymphatic System Research
- Oncology and Metastasis
Background:
- Uncertainty exists regarding lymphatic vessel presence in normal intervertebral discs.
- The role of lymphatics in spinal pathology, including degeneration and infection, is unclear.
- Understanding spinal lymphatics is crucial for diagnosing and treating spinal disorders.
Purpose of the Study:
- To investigate the presence of lymphatic vessels in normal pediatric and adult spinal tissues.
- To determine if lymphatic vessels are present in pathological spinal lesions.
- To clarify the role of lymphatics in spinal disease and metastasis.
Main Methods:
- Immunohistochemical analysis using lymphatic endothelial cell markers (podoplanin, LYVE-1).
- Examination of normal cervical, thoracic, and lumbar disc and vertebral tissues from children and adults.
- Analysis of various pathological spinal disorders, including degenerative, infectious, and neoplastic conditions.
Main Results:
- No lymphatic vessels were detected in intact normal intervertebral discs or vertebrae of any age group.
- Lymphatics were observed in the outer periosteum, paraspinal ligaments, and surrounding connective tissues.
- Lymphatic vessels were present in infected and degenerated disc tissues, and in vertebral bone with neoplastic lesions extending beyond the cortex.
Conclusions:
- Normal spinal vertebrae and intervertebral discs lack lymphatic vessels.
- Lymphatics in pathological spinal conditions likely arise from surrounding connective tissues.
- Findings suggest spinal lymphatics are not involved in metastatic tumor spread; lymph node involvement occurs after extraosseous spread.
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