Spinal anastomosed remnant imprints of vertebral veins linking the transverse foramina: a case report of a novel anatomic variant of the cervical venous plexus.

PURPOSE: Despite various postulated classifications attempting to simplify the complex angioarchitecture of the cervical spine, the nomenclature of spinal variants and lesions remains inconsistent. Knowledge of variations in the anatomy of the vertebral veins will assist in avoiding complications during neck surgery and procedures such as vertebroplasty. In addition, venous variants may act as a route for the spread of infection, emboli, or metastases. Therefore, we report a novel variant encountered at our institution in this case report. METHODS: We coincidentally discovered an original anatomical variant of the cervical venous plexus linking the transverse foramina in a Saudi man. RESULTS: We termed the variant "spinal anastomosed remnant imprints" (SARI), guided by the second edition of Terminologia Embryologica, a project of the Federative International Programme for Anatomical Terminology. This variant anastomoses with the vertebral veins at the same level, forming segmented osseous impressions. It shares a topographical relationship with the embryonic anterior cardinal veins, which normally regress in the prenatal period. We hypothesize that these intersegmental anastomosing veins do not always regress and may persist into adulthood, with individualized variations of the venous circulation. CONCLUSION: This report highlights an important finding of interpersonal anatomical variation of veins in the cervical spine, discovered with the aid of advanced imaging to distinguish it from pathological conditions. This will be of assistance to radiologists, anatomists, and clinicians in decision-making and to surgeons in planning for neck surgery.