Spinal Dural Arteriovenous Fistula Presenting as a Recurrent Nucleus Pulposus Herniation by Kushagra Verma, Jacob Fennessy, Ronald Huang, Pascal Jabbour,

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Spinal Dural Arteriovenous Fistula Presenting as a Recurrent Nucleus Pulposus Herniation by Kushagra Verma, Jacob Fennessy, Ronald Huang, Pascal Jabbour, and Jeffrey Rihn JBJS Case Connect Volume 5(3):e59 July 8, 2015 ©2015 by The Journal of Bone and Joint Surgery, Inc.

Sagittal view demonstrating evidence of a large disc extrusion at L1-L2 (versus disc extrusion with facet hypertrophy) as well as additional disc herniations at L2-L3 and moderate to severe spinal stenosis at L4-L5 with multilevel degenerative disc disease... Kushagra Verma et al. JBJS Case Connect 2015;5:e59 ©2015 by The Journal of Bone and Joint Surgery, Inc.

Kushagra Verma et al. JBJS Case Connect 2015;5:e59 ©2015 by The Journal of Bone and Joint Surgery, Inc.

Kushagra Verma et al. JBJS Case Connect 2015;5:e59 ©2015 by The Journal of Bone and Joint Surgery, Inc.

Figs. 1-B, 1-C, and 1-D Axial views at the level of the L1-L2 disc space demonstrating disc extrusion (versus disc extrusion with facet hypertrophy) causing severe neuroforaminal narrowing of the lateral recess. Kushagra Verma et al. JBJS Case Connect 2015;5:e59 ©2015 by The Journal of Bone and Joint Surgery, Inc.

Kushagra Verma et al. JBJS Case Connect 2015;5:e59 ©2015 by The Journal of Bone and Joint Surgery, Inc.

Kushagra Verma et al. JBJS Case Connect 2015;5:e59 ©2015 by The Journal of Bone and Joint Surgery, Inc.

Kushagra Verma et al. JBJS Case Connect 2015;5:e59 ©2015 by The Journal of Bone and Joint Surgery, Inc.

Kushagra Verma et al. JBJS Case Connect 2015;5:e59 ©2015 by The Journal of Bone and Joint Surgery, Inc.

Kushagra Verma et al. JBJS Case Connect 2015;5:e59 ©2015 by The Journal of Bone and Joint Surgery, Inc.

Kushagra Verma et al. JBJS Case Connect 2015;5:e59 ©2015 by The Journal of Bone and Joint Surgery, Inc.

Left L1 segmental artery injection showing a racemic arteriovenous fistula with an early draining vein going cephalad. Kushagra Verma et al. JBJS Case Connect 2015;5:e59 ©2015 by The Journal of Bone and Joint Surgery, Inc.

Left L2 segmental artery injection showing the arteriovenous fistula and the dilated vein. Kushagra Verma et al. JBJS Case Connect 2015;5:e59 ©2015 by The Journal of Bone and Joint Surgery, Inc.