Objective:  To determine the surgical Outcome for a prolapsed lumbar intervertebral disc based on a visual analog score. Materials and Methods:  A prospective study was conducted in the Department of Neurosurgery at Jinnah Postgraduate Medical Centre, Karachi. A total of 55 patients were included in the study. Questionnaires were used to collect demographic data, presenting symptoms, and the level of the herniated discs. The patients underwent different surgical interventions and then these patients were followed for 2 weeks postoperatively and the surgical outcome was assessed using the Visual Analog Score (VAS). Results:  A total of 34 (61.8%) males and 21 (38.2%) females were included in this study. The average age of the patients was 36.14 ± 9.30 years. L5/S1 was the most commonly affected level. Laminar fenestration was the most common surgical procedure done in 23 (41.8%) patients followed by hemilaminectomy in 19 (34.5%) patients and bilateral laminectomy in 13 (23.6%). Post-operative pain was relieved in the majority of patients which is 43 (78.2%). Conclusion:  Medical management remains the mainstay in the majority of patients having lumbar disc prolapse. However, in cases where the pain is refractory to conservative management, surgery is considered after careful patient selection. It was seen that surgical intervention successfully reduced the intensity of pain and resulted in a symptomatically improved patient. Hence it is safe to conclude that surgery is an effective measure and ultimately enhances the quality of life.

Background: Ventriculoperitoneal shunt (VPS) is one of the most common procedures for the treatment of hydrocephalus. However, there are a number of complications associated with it. Case Presentation: We aim to present a rare complication of complete intraventricular migration of the VPS system. Our patient was a 12-month-old child who presented 8 months following placement of a right VPS for congenital hydrocephalus. He complained of progressive enlargement of head and vomiting. Examination did not reveal any palpable shunt under the skin on head, neck, or torso. An X-ray showed the presence of the complete shunt coiled within the ventricles. The shunt was removed endoscopically and third ventriculostomy was performed. Conclusion: Complete intracranial migration of VPS is a rare complication and can be avoided by making a small burr hole and careful anchoring of shunt. Trans-cranial endoscope is a useful tool for retrieval in such case and avoid more invasive procedure.

Objective:  To explore the result and frequency of different problems that occur in the early post-operative period and the incidence of these complications in our community. It will give insight and drive further development in the care of myelomeningoceles as well as the unique problems that emerge in these patients post-operatively. Materials and Methods:  At the Jinnah Postgraduate Medical Center in Karachi, the Department of Neurosurgery, this prospective, observational study was carried out over 12 months. Patients of both genders from 1 month to 2 years of age, diagnosed with myelomeningocele, and admitted to the ward for surgical repair were included in the study. Results:  Out of 94, there were 58.5% female patients, with the highest percentage of age group i.e. 48.9% in > 3 months to 9 months. Medium size of MMC (71.3%) at the lumbar side location (46.8%) was observed in the highest frequency among the study sample. The overall postoperative complication rate was 19.1%, with CSF leak being the most common (9.6%) followed by wound infection (5.3%). There was no association of the complications with the age, size, and location of MMC. Conclusion:  Myelomeningocele treatment may be delayed as a result of distant homebirths. Neurosurgeons who are trying to give prompt access to medical care for individuals born with MMC face various hurdles, including the family's desire to seek medical attention, their capacity to do so, and the availability of proper medical treatment.