The vertebral vein is a paired vessel found in the transverse foramina of the cervical vertebrae on either side of the neck. It arises at the level of the sixth cervical vertebra from a venous plexus that surrounds the vertebral artery and travels as far as the brachiocephalic veins. Note that some authors consider the mentioned venous plexus as a proximal part of the vertebral vein, rather than its parent vessel. For the sake of clarity, we should emphasize that this venous plexus arises within the suboccipital triangle and traverses the transverse foramina up to the C6 level, after which it is continued by a single vertebral vein on each side of the neck.
The function of the vertebral vein is to drain the venous blood from the cervical spine, prevertebral and suboccipital muscles. It terminates low in the neck by emptying into the brachiocephalic vein.
|Drains from||Union of internal vertebral venous plexuses, a branch of occipital vein, veins of suboccipial and prevertebral muscles|
|Tributaries||Occipital vein, anterior vertebral vein, accessory vertebral vein, suboccipital venous plexus|
|Drains to||Brachiocephalic veins|
|Drainage area||Suboccipital muscles, prevertebral muscles, cervical spine|
This article will discuss the anatomy and function of the vertebral vein.
Anatomy and course
The vertebral vein emerges within the suboccipital triangle, above the posterior arch of atlas (C1). It arises from the internal vertebral venous plexuses, a branch of the occipital vein and the veins that drain the suboccipital and prevertebral muscles. These veins anastomose with each other and form a venous plexus, which enters the transverse foramen of atlas and surrounds the vertebral artery. This plexus is sort of a predecessor of the vertebral vein and it traverses the transverse foramina of cervical vertebrae C1-C6. At the level of the C6 transverse foramen, the plexus unites into a single vessel - the vertebral vein.
The vertebral vein then courses inferiorly crossing the lateral sides of the cervical vertebrae, initially lying over the anterior aspect of the vertebral artery and then crossing over its anterolateral side. It passes over the anterior aspect of the first part of the subclavian artery, being posterior to the internal jugular vein.
The vertebral vein terminates by emptying into the brachiocephalic vein via the orifice that usually features a two-leaved valve.
Along its course, the vertebral vein receives the following tributaries;
- Within the suboccipital triangle, it receives the communicating branches from the suboccipital venous plexus
- Communicating branches from the external venous plexuses at each intervertebral level from C1 to C6
- Anterior vertebral vein, which joins the vertebral vein just prior to its termination in the brachiocephalic vein
- Deep cervical vein, which empties into the vertebral vein once it passes onto the anterolateral surface of the vertebral artery
The vertebral vein often gives off a continuation at the level of the transverse foramen of C6; the accessory vertebral vein. This vessel passes through the transverse foramen of C7, takes a sharp anterior course and empties into the brachiocephalic vein.