IntroductionIntracranial chondromas are rare benign tumors with an incidence of 0.2% to 0.3% of all intracranial tumors. This is the first case of an intracranial chondroma reported from Pakistan.Case presentationWe report a case of a 23-year-old Asian man presenting with intracerebral chondroma of the left frontal lobe, which was eroding the dura matter. The intracranial chondroma was completely removed by surgery.ConclusionIntracranial chondromas are rare benign cartilaginous tumors. Through this case presentation we have discussed the diagnostic procedures, radiological and pathological findings. The purpose of presenting such a rare case is to develop awareness among clinicians and medical students and to highlight the requirement of immediate actions to ensure proper management of such cases.

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Aim: The purpose of the study was to assess the outcome of epidural infiltration of local anesthetic and steroid intraoperatively in comparison with placebo (saline) after lumbar discectomy. Study Design: A prospective double blinded randomized controlled trial conducted in a tertiary care centre over two and half years’ duration, from July 2019 to December 2021 Methods: 70 subjects enduring lumbar discectomy were randomised to the intraoperative infiltration of triamcinolone acetonide (40mg/ml, 2ml) and bupivacaine (0.5%, 3ml) in A group or B group who were given equal (5ml) volume of normal saline. Infiltration was achieved after decompression and discectomy, and just before the incision was closed. In the postoperative period, the standard procedure of physiotherapy and intravenous paracetamol administration were used. Supplementary analgesics with tramadol was used solitary in patients requiring greater pain control. The VAS scale was used to access pain post-operatively and use of opioids was documented. Primary outcomes measures included immediate post-operative VAS back pain, infection rate and opioid use. The subjects were reassessed at six-weeks and three months after surgery. Results: No patient in A group needed opioid analgesic while 14 patients in group B needed additional tramadol as a pain killer for pain relief (p = 0.01). At the third hour after surgery, the VAS result was lower significantly in A group in comparison to the group B (p <0.05). No infection or other serious complication was reported and no revision surgery was performed in either group. One patient in each group stated residual radiculopathy, but after 6 weeks both patients’ symptoms resolved. Conclusions: Intraoperative administration of local anaesthetics and steroids is fruitful in reducing pain only for a brief time afterwards the surgical procedure, without affecting the infection rate and long-standing outcomes in comparison to the placebo. Keywords: Triamcinolone, Bupivacaine, Lumber discectomy, Postoperative pain

Aim: A retrospective analysis of the outcome of anterior cervical discectomy and fusion comparing cage-only and cage-and-plate fixation on the basis of radiographic changes. Setting: In the department of Neurosurgery of a tertiary care hospital for two-year duration from January 2019 to December 2020. Methods: 56 patients who endured one-level ACDF (n = 34) and two-level ACDF (n = 22) for cervical disc disease were enrolled in the study and underwent a 12-months follow-up. Patients were separated according to cervical level and divided into cage-only group (ACDF-C) and cage-and-plate fixation group (ACDF-CP). The subsidence and status of fusion were evaluated on the radiography. Results: Comparing the ACDF-C with ACDF-CP at one level, the subsidence was detected in 50% of patients in the former group and in 33.3% of cases in the later at 12 months follow up. The two groups do not have statistically significant variance in terms of occurrence percentage (p = 0.32). In the two levels comparison of ACDF, ACDF-C had significantly more subsidence (75%) than the ACDF-CP group (28.5%; p= 0.046). The rate of fusion in single level ACDF of ACDF-C was not much different on statistics from that in the ACDF-CP group (87.5% and 88.8%, p= 0.43). The fusion was also similar in the two levels ACDF (ACDF-C= 87.5% and ACDF-CP= 92.8%; p= 0.30). Conclusions: This study’s radiological outcome did not exhibit any extra advantage of plate fixation compared to the cage-only in the 1-level ACDF subjects; however in ACDF at 2-level, a subsidence is much more probable without fixation of plate and therefore adding a plate to cage must be taken important. Keywords: cervical plate, cervical discectomy, spinal fusion, subsidence.