The Anatomic Structural Features Of The Iliolumbar And Ascending Lumbar Vein And It's Clinical Significance

Objective To investigate anatomic structural features of the lumbosacarl veins and provide anatomic bases for clinical lumbo- sacarl anterior approachMethods We dissected the iliolumbar veins and ascending lumbar veins from 20 formaldehyde-preserved cadavers(17male,3 female).The points of confluence with the common iliac vein and drainage pattern of the iliolumbar vein and ascending lumbar vein were ascertained. The diameter and the length of the iliolumbar vein and ascending lumbar vein were measured. The distance from the common iliac vein confluence and L5 vertebra's inferior end plates to the iliolumbar vein and ascending lumbar vein were measured, and the relationships of the iliolumbar and ascending lumbar vein with the lumbosacral trunk, obturator nerve, and iliolumbar artery were ascertained. An assessment of the risk of avulsion was made for each vein, by medially retracting the inferior vena cava and common iliac vessels in order to expose the L4-S1 vertebral body bilaterally.Results The iliolumbar vein were detected on both sides of all 20 cadavers,but there was no ascending lumbar vein in five sides. In all dissections, the iliolumbar vein and ascending lumbar vein drained blood gathered from the iliacus and psoas muscles and the fifth lumbar vertebral body. Eleven drainage patterns were seen between the iliolumbar vein and the lumbosacral major veins.There were five drainage patterns in the ascending lumbar vein. The mean length of the iliolumbar vein was 7.89±3.30mm and at it's mouth the mean diameter was 4.95±1.08mm. The mean distance from iliolumbar vein to the common iliac vein confluence was 49.10±14.93mm and from the iliolumbar vein to the L5 vertebra's inferior end plate was 13.94±6.94mm. The mean length of the ascending lumbar vein was 12.94±5.89mm and at it's mouth the mean diameter was 5.20±2.69mm. The mean distance from the ascending lumbar vein to the common iliac vein confluence was 43.98±10.77mm and from the ascending lumbar vein to the L5 vertebra's inferior end plate was 15.60±8.28mm. In all cases, the obturator nerve crossed superficial lateral to the iliolumbar and ascending lumbar vein. In 26 of the 35 cases, the lumbosacral trunk was lateral to ascending lumbar vein. In the other 9 cases,the lumbosacral trunk was deeper when compared with the ascending lumbar vein. In 29 of the 40 cases, the lumbosacral trunk passed deep to the iliolumbar vein while in 8 cases, it passed superficial to it. In the other 3 dissections, the lumbosacral trunk bifurcated around the iliolumbar vein.This was not previously reported.Conclusions The iliolumbar and ascending lumbar vein distributed in the L5 vertebra's sides and drained blood gathered from the L5 vertebral body.In fact The iliolumbar and ascending lumbar vein were equal the segment blood vessel of the fifth lumbar vertebral body Due to they have an intimate relationship with the obturator nerve and lumbosacral trunk and have numerous Anatomic variations,when anterior approaches to the lumbosacral spine are used for the treatment of different spinal problems, careful dissection and ligation of these veins is necessary to avoid complications. Due to the risk of damaging these nerves, we feel that diathermy should not be used to control the iliolumbar vein and ascending lumbar vein.