A comparison of vertebral venous networks in adolescent idiopathic scoliosis patients and healthy controls

Purpose - Cadaveric studies have previously documented a typical pattern of venous drainage within vertebral bodies (VBs), comprised primarily of the basivertebral vein. These studies, however, are limited by the number of samples available. MRI is able to provide 3D images of soft tissue structures in the spine, including the basivertebral vein without the use of contrast in both healthy controls and subjects with abnormal anatomy such as adolescent idiopathic scoliosis (AIS). This study aimed to quantify the venous networks within VBs of 15 healthy adolescent controls and 15 AIS patients. Methods - Five transverse slices through the VBs were examined simultaneously and the observable vascular network traced. The length of the network on the left and right sides of the VB was calculated, and the spatial patterning assessed level-by-level within each subject. Results - Significant differences were seen in the left/right distribution of vessels in both the control and AIS subjects, with both groups having greater length on the right side of all of their VBs. Large individual variations in patterns were seen in both groups; however, the control group showed more consistent spatial patterning of the vascular networks across levels in comparison to the AIS group. Conclusion - The length of the basivertebral vein was seen to have a significant bias to the right hand side of the VB in both healthy and AIS adolescents. The spatial pattern of this vein showed large variations in branching both within and across individuals. No significant differences were seen between AIS and control subjects, suggesting both that this network is preserved in deformed AIS vertebrae, and that the vertebral venous system does not play a role in the aetiology of AIS