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Hemodynamic alterations in the paravertebral venous plexus after spinal injury
V N Cassar-Pullicino1, E Colhoun, M McLelland
1Department of Diagnostic Imaging, Robert Jones and Agnes Hunt Orthopaedic and District Hospital, Oswestry, Shropshire, England.
Purpose:
To assess the prevalence of altered venous hemodynamics after spinal cord injury.
Materials And Methods:
The authors performed venography in 200 ambulant patients and 107 patients with spinal injury. The hemodynamic characteristics of the paravertebral venous plexus were documented after pedal injection of contrast material. The hemodynamic and clinical data were correlated in patients with spinal cord injury.
Results:
Abnormal venous return via the paravertebral venous plexus in the absence of iliac or inferior vena caval occlusion was shown in 73 (68%) of the 107 patients with spinal injury. This paravertebral venous flow route is not related to the time between injury and examination. It was demonstrable in the early as well as late post-traumatic period and was reproducible at subsequent examinations. The paravertebral venous flow route was more commonly seen in cervical than thoracolumbar injuries and was closely related to the severity of neurologic deficit (P = .0012).
Conclusion:
Abnormal vertebral venous hemodynamics occur in most patients with spinal cord injury and are more likely to occur in patients with complete neurologic deficit and cervical injury.