Extraforaminal stenosis at the lumbosacral junction is less common than intraspinal canal lesions, and the radiological diagnosis is less established. We present 10 cases that presented with neurological deficits compatible with a diagnosis of L5 radiculopathy, such as sensory disturbance in the L5 area associated with neurogenic claudication. Radiography demonstrated lumbar scoliosis and wedging of the L5-S1 intervertebral space in 6 patients, and transitional vertebra (Castellvi types IB, IIA, and IIB) in 6 patients. Computed tomography demonstrated marked osteophyte formation at the posterolateral margin of the L5-S1 vertebral bodies in all 10 patients. Coronal constructive interference in steady-state magnetic resonance imaging showed extraforaminal entrapment of the L5 root. Decompression procedures included partial resection of the L5 pars interarticularis, sacral ala, and L5 transverse process along the L5 spinal nerve. Osteophytes of the L5-S1 vertebral bodies were also resected in 6 patients because they limited mobility of the nerve roots. Complete decompression was achieved with posterior bone resection in the other 4 patients. Pain relief was achieved in all patients. Our results demonstrate that simple decompression surgery using a surgical microscope is an effective and less invasive surgical option for patients with extraforaminal compression of the fifth lumbar spinal nerve at the lumbosacral junction.

  Objective : We analyzed the clinical presentation, therapeutic outcome, and intraoperative findings of thoracolumbar dural arteriovenous fistula (T-L dAVF).

  Method and material : We experienced 19 cases (16 men) of T-L dAVF between 1996 and 2011 and analyzed the clinical characteristics and outcome after intravascular embolization and direct surgery. Additionally, we analyzed intraoperative findings among the cases that underwent direct surgery.

  Result : The mean patient age was 63.8 years, and the mean follow-up period after intravascular embolization and/or direct surgery was 72.2 months. All patients suffered congestive myelopathy. Intravascular embolization was performed in 15 cases. All 4 patients who underwent feeder occlusion with coil material had a relapse and required direct surgery. Eight of eleven patients treated with n-butyl cyanoacrylate (NBCA) were cured. One patient suffered a spinal infarction after embolization. Three cases treated by NBCA showed recurrence and required direct surgery. All 10 cases that required direct surgery were cured without any complications. During the direct surgeries, single draining vein was observed in all 10 cases. The draining vein was located dorsally against the posterior rootlet in 8 cases, ventrally in 1 case, and intraforaminally in 1 case. Vascular tangle was observed on the outer surface of the dura mater in 4 cases, on the inner surface of the dura mater in 3 cases, and on both the inner and outer surfaces in 2 cases. The fistulous point was located around the dural sleeve or the corresponding pedicle in all but 1 case.

  Conclusion : Regarding therapy for T-L dAVF, direct surgery may be more promising than intravascular embolization, although the latter can be performed less invasively. We must remember that cases of T-L dAVF in which the fistulae are located far from the dural root sleeve or corresponding pedicle are rare.

  Background and Objecttive : Sciatic scoliosis caused by lumbar disc herniation is also known as functional scoliosis, which can be treated with discectomy ; However, there have been few reports on the appropriate surgical management of severe sciatic scoliosis and the post operative changes.

  The authors report experiences of 2 patients who had a Cobb angle greater than 20° and showed reduction in scoliosis after discectomy.

  Clinical presentation : Case 1. A 23-year-old woman who had pain in her right leg and numbness caused by L4/5 disc herniation for 4 years presented with severe scoliosis and an L2-5 Cobb angle of 31.3° before surgery. After discectomy, her scoliosis improved to 10.1° in 1 month and 7.9° in 4 months. Case 2. A 30-year-old man who had pain in his left leg and numbness and low back pain caused by L4/5 disc herniation for 3 months presented with scoliosis and an L1-5 Cobb angle of 24.7° before surgery. After discectomy, his scoliosis improved to 5.4° in 1 month and disappeared in 3 months.

  Conclusions : Two patients with severe sciatic scoliosis due to lumbar disc herniation before surgery showed improvement in scoliosis from the early period after discectomy without spinal fixation. The authors suggest that discectomy without spinal fixation is an adequate surgical approach for sciatic scoliosis, even if the scoliosis is severe.

  A 40-year-old woman presented with unbearable low back pain that followed a witnessed epileptic seizure without any external injuries. This epileptic seizure was her first episode. Magnetic resonance imaging (MRI) and computed tomography (CT) revealed a compressed vertebral fracture at L3. She had no riskfactors for fractures such as osteoporosis, except for chronic alcoholism.

  Non-traumatic compressed fracture of the lumbar vertebral body is a rare entity. This type of injury may be due to the compressive force exerted on the vertebral column by the contraction of the trunk muscles during an epileptic seizure. Balloon kyphoplasty was performed, and she did not experience any symptoms postoperatively.

  This case emphasizes the importance of thorough examinations of patients after generalized convulsions.