Lumbar disc disease is a commonly encountered spine problem. There have been various modalities of treatment that have evolved over the years. The objective of our study is to analyze safety, efficacy, and complications following Micro-lumbar discectomy. All the cases admitted in our spine clinic with symptomatic lumbar disc and who underwent Micro-lumbar discectomy between February2013 to February 2018 were included in our study. Seventy cases were operated during this period. Total operative time, immediate and long term outcome with regards to pain and neurological deficits were tabulated and analyzed for each patient. Furthermore, short and long term complications including wound infection, discit is, instability and recurrence at the same level were also studied and compared with similar studies from the literature. None of our cases had complications related to wound infection, instability or post-operativediscitis. Immediate relief from the radicular pain experienced in the pre-operative period was seen in all patients (Visual analog scale) though benign tingling sensation persisted in a few of them that improved in a short span of time. Recurrence was seen in only one case. Micro-lumbar discectomy is a minimally invasive spine procedure conferring high benefits to the patients. While compared to other methods of intervention, it has a low risk of complications as well as chances of disc recurrences.

Objective: The surgical management of compound depressed fractures overlying dural venous sinuses confers major challenges for the neurosurgeons. On one hand, the depressed fracture and associated compound wound herald the risk of venous occlusion and fatal brain swelling, on the other hand, the surgical attempt in managing them foresees major risks of bleeding and air embolism. Materials and Results: A retrospective analytical study was conducted from the hospital records pertaining to the cohorts of patients admitted with traumatic fractures overlying major dural venous sinuses. Among 45 patients included on our study, six patients were managed conservatively, and the rest 39 patients required surgical intervention due to compound depressed fractures heralding high risk of venous flow obstruction. The age of our patients ranged from 6 to 60 years with a high male predominance (77% vs. 22.22%).The most common mode of injuries was road traffic accidents in 66.67% (30/45) of cases. The most common location of depressed fracture was in the anterior third of SSS, seen in 57.77% of cases. The surgical complications were seen is 2.23% of cases, with the single instances of air embolism, profuse bleeding and cortical venous thrombosis seen respectively. The overall mortality seen in our study was 6.67%, whereas the operative mortality was only 4.45%. Conclusion: The refinement in the surgical nuances has now enabled us in managing depressed fractures overlying major dural venous sinuses with minimal risks of complications, thereby preventing the high risks of venous hypertension they otherwise invariably harbinger.

Background: Stroke is a significant global health hazard that ripples continuum multi-spectral effects to the patients as well their caretakers.   Methods: We studied 28 consecutive cohorts of patients with recurrent strokes managed in our centre within the last two years.  Results: The most common recurrence stroke pattern was of that of hemorrhagic to hemorrhagic subtype observed in 50% of the patients. The most common anatomical region of involvement was cortical – cortical seen in 39.28% of our cohorts. The surgical intervention was required in 17.85% whereas 42.85% of them were managed conservatively. Paradoxically, 39.28% of patients left against medical advice. The receiver operating curve (ROC) predicting mode of management was highest (area under the curve (AUC) =0.635) for compliance to therapy followed by stroke territory (AUC=0.578), age (AUC=0.457) and motor grading (AUC=0.374). The receiver operating curve (ROC) for influencing decision to leave against medical advice was highest (area under the curve (AUC) =0.861) for motor score followed by sex (AUC=0.701) and age (AUC=0.564). The analysis of variance (ANOVA) study pertaining to the mode of management was significantly connoted by the motor score and the stroke territory only. The ANOVA study pertaining to the decision to leave against medical advice was significantly governed by the motor score, stroke territory, and sex respectively. The multivariate analysis for variables governing mode of management was significant for motor score and the stroke territory only. The multivariate analysis for variables governing leave against medical advice was significant for sex, motor score and the stroke territory.  Conclusions: This study aims to appraise early dichotomization of high-risk patients for recurrent strokes to reduce the continuum of neurological events as well as to mitigate the financial aspects governing stroke care.