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As any other organ, the spinal cord also suffers in chronic congestion. Since the epidural venous system drains into the vena cava system and participates in collateral circulation, there is increased inflow with impaired blood flow along its large tributaries in the vertebral canal along with poor outflow, resulting in intracanal hypertension and chronic congestion. Venous hemodynamic disorders are found beyond the vertebral canal and detected by selective phlebography of the large tributaries of the vena cava system. The technique was used to examine 46 patients with spastic paraparesis or tetraparesis of unclear etiology, which provides evidence for the fact that vena cava stenoses, compressions, atresia, and thromboses can be responsible for impaired venous hemodynamics in the vertebral apparatus and its surgical correction is possible.

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