The herniated intervertebral disc is among the most prevalent afflictions that lead to low back pain and neurological dysfunction and disputed that there is a need for spinal decompression. In Pakistan, the neuroanatomical factors related to the treatment of this condition have not been well- studied. This study aims to assess the outcome of patients with lumbar disc herniation who undergo spinal decompression surgery using neuroanatomical parameters as a basis. Initial data shows that there was significant pain relief with a mean difference of 3.5, p < 0.01 with functional recovery being seen in 85% of the respondents, nerve root involvement being crucial. These findings indicate that without accurate neuroanatomical ‘gating’ of the surgical procedures, surgical success will be limited. In low resource countries like Pakistan, such approaches can maximize improvement and provide new evidence with relevance to the treatment of lumbar disk herniation.