Cerebrospinal fluid

Lumbar

Surgery

Embolization

Lumbar puncture

Intervertebral foramen

Venous plexus

Radiology

Foramen

Anatomy

Fistula

Medicine

Pathology

American Journal of Neuroradiology

<h3>SUMMARY:</h3> CSF-venous fistula is a relatively novel entity that is increasingly being recognized as a cause for spontaneous intracranial hypotension. Recently, our group published the first series of transvenous embolization of CSF-venous fistulas in this journal. Having now performed the procedure in 60 patients, we have garnered increasing familiarity with the anatomy and how to navigate our way through the venous system to any intervertebral foramen in the cervical, thoracic, and lumbar spine. The first part of this review summarizes the organization of spinal venous drainage as described in classic anatomy and interventional radiology texts, the same works that we studied when attempting our first cases. In the second part, we draw mostly on our own experience to provide a practical roadmap from the puncture site to the foramen. On the basis of these 2 parts, we hope this article will serve to collate the relevant anatomic knowledge and give confidence to colleagues who wish to embark on transvenous spinal procedures.

Anatomy of Spinal Venous Drainage for the Neurointerventionalist: From Puncture Site to Intervertebral Foramen