OBJECTIVES To evaluate the effectiveness of disc excision in the treatment of herniated lumbar intervertebral disc.METHODOLOGY METHODOLGY This study was conducted in the Department of Neurosurgery, Lady Reading Hospital, Peshawar. A total of 62 patients had moderate to severe radicular pain due to Prolapsed intervertebral disc at L4/5 or L5/S1. All the enrolled patients were subjected to disc excision surgery. Postoperatively the patients were kept for 48 hours for observation and then discharged. All the patients were advised to come after 2 weeks for the follow-up to check effectiveness. RESULTS The mean age of patients was 34.59± 7.49 years. There were 64.5% male and 35.5% female. 53.2% of patients had L4-L5, 33.9% of patients had L5-S1 and 12.9% of patients had both L4–L5 and L5–S1 level disc herniation. 85.5% of patients had no pain, 8.1% had mild pain and 04.8% had moderate pain. Postoperatively 79.0% of patients were satisfied. CONCLUSION As compared to conservative care limited disc excision is safe, effective, and reliable in terms of pain. Disc excision technique provides immediate relief from radicular pain.

OBJECTIVES: To compare the effectiveness of Endoscopic (endonasal transsphenoidal) repair of CSF leak with transcranial approach in terms of post-operative complications.  METHODOLOGY:   This study was conducted in the Department of Neurosurgery, Lady Reading Hospital, Peshawar. Total of 40 patients diagnosed according to inclusion criteria were enrolled and were divided into two groups. One group was treated with endonasal trans-sphenoidal repair, and another was treated with a trans-cranial approach. All patients were followed for 1 year.  RESULTS:  The mean age of enrolled patients was 35.4±11.6 years. There were 62.5% male and 37.5% female. In the endoscopic group the recurrence rate was observed in 3 (15%) of the patients while in the trans-cranial group the recurrence rate was observed in 2 (10%) of the patients. The overall recurrence and success rate was 8% and 92% respectively. About 4 patients developed an infection, which was treated successfully.  CONCLUSION:  It is concluded that the endoscopic approach is safe and effective. The endoscopic approach should be considered as standard procedure for treatment.

OBJECTIVES: The purpose of this study was to analyze the main source of bleeding and operative findings in an extradural hematoma (EDH).   METHODOLOGY: This study was conducted in the Department of Neurosurgery, Lady Reading Hospital, Peshawar. The sample size of the study was analyzed through WHO sample size calculator and 300 diagnosed patients were recruited by purposive sampling technique. Ethical approval was taken from the College of Physicians and Surgeons Pakistan (CPSP) and the hospital’s ethical committee. By using the SPSS version 23.0, all the collected data were analyzed. RESULTS: The mean age of enrolled patients was 27.96±12.71 years. There were 65.7% male and 34.3% female. The most common age group was 21–30 years followed by 31 to 40 years and 11 to 20 years with the most common source of bleeding was middle meningeal artery, 39.7% of patients fall in the temporal parietal category. CONCLUSION: Middle meningeal artery is the most common source of bleeding in EDH. Therefore, proper management of this vessel is significant to avoid the chances of re-bleed and re-do surgeries.

OBJECTIVES: To determine the post-operative neurological outcome of intradural spinal tumors in terms of improvement in McCormick classification scheme.METHODOLOGY:  Total of 95 patients diagnosed as case of intradural spinal tumor as per operational definition with any McCormick grade were analyzed. After admission and complete neurological examination, pre-operative McCormik’s grades of each patient were determined and followed for one month after surgery. During their stay they were assessed for neurological improvement as per McCormick grade.RESULTS:There were total 95 patients presenting in OPD with the mean age of 45±12.36 years. There were 42% male and 58% female. There were 62% patients who were improved in neurological outcome while 38% patients were not improved. CONCLUSION:Surgical removal of spinal tumor is beneficial to the affected individual and has positive effect on his life.