Introduction: Subcutaneous hemangioma is a rare variant of slow-flowing venous malformation. It occurs in both adults and children and is more common in women. It exhibits an aggressive growth pattern, can occur anywhere in the body, and may recur after resection. This report shows a rare localization of hemangioma in the retrocalcaneal bursa. Case Report: A female patient, age 31, presented with swelling and pain over the retro calcaneum region for 1 year. The pain in the retrocalcaneal region has increased with gradual intensity over the past 6 months. The swelling she described to be insidious in onset and gradually progressive. Examination findings at presentation were a middle-aged female with diffuse swelling in the retrocalcaneal region with a size of 2 cm by 1.5 cm. Based on the X-ray, we defined it to be myositis ossificans. With this view in mind, we admitted the patient and surgically excised the area. We operated by posteromedial approach and sent the specimen for histopathology. Pathology revealed calcified bursa. Microscopically, it was hemangioma with phleboliths and osseous metaplasia. The post-operative period was uneventful. The patient’s pain was reduced, and overall performance was good at follow-up. Conclusion: This case report highlights the importance for surgeons, pathologist to consider cavernous hemangioma as a differential diagnosis for retrocalcaneal swellings. Keywords: Cavernous hemangioma, retro calcaneal region, rare tumor

Background: In most of the institutes Lumbar Microdiscectomy surgery is done under General Anaesthesia. However, it is not uncommon to do these surgeries under Spinal Anaesthesia Aims and objectives: To compare the analgesic effectiveness in postoperative pain, cost-effectiveness and complications of spinal anaesthesia and general anaesthesia who underwent single Level Lumbar Microdiscectomy under General Anaesthesia vs who were administered Spinal anaesthesia for the same Materials and methods: A prospective observational study was conducted on patients undergoing lumbar micro-discectomy in the department of orthopaedics of a tertiary care hospital in Maharashtra, India. The study duration was two years [January 2020 to December 2020]. The patients older than 18 years who were not responding to 6 weeks of conservative therapy, epidural steroid injection, physiotherapy, and having low back pain with radiculopathy with claudication with or without neurological deficit were included in the study. We included 25 cases each in the spinal anaesthesia (SA) and general anaesthesia (GA) group. Outcome variables like peri-operative complications (blood loss, urinary retention, PONV), surgery length, length of stay (LOS), time from entering OT to incision, time from bandaging to exit time, and time of stay in the recovery room were studied among both the groups. Chi-square or fishers exact test to test the difference between proportions and student t-test to test between the means were statistical tests used. Results: The VAS score reduction immediately post-operative among GA group was 79% and SA group was 75% and this difference was not significant. (p>0.05)The time from post anaesthesia care unit from operation theatre [GA Vs. SA; 60.44 minutes Vs. 20.45 minutes] , time of surgery (time to enter in OT to incision) [GA Vs. SA; 30.22 minutes Vs. 15.55 minutes], time from bandaging to exit from OT[GA Vs. SA; 16.34 minutes Vs. 6.12 minutes] and average hospital stay[GA Vs. SA; 3.05 days Vs. 1.61 days] were significantly higher among GA group when compared to SA group. (p<0.05) The average cost of procedure among GA group was 26500 INR and among SA group was 18500 INR. (p<0.05) Conclusions: In terms of VAS pain score reduction, SA was comparable with GA. Our study showed that SA was superior to GA in terms of time consumption, cost, and hospital stay while maintaining better perioperative hemodynamic stability without increasing adverse side effects. Keywords: Lumbar micro-discectomy, Spinal Anaesthesia, General Anaesthesia, Cost-effectiveness