Recurrent lumbar disk herniations (rLDHs) are becoming a common occurrence in present times. However, the optimal surgical strategy for their management is a not clear with discectomy alone and discectomy followed by fusion emerging as the main surgical options. In this editorial debate, we discuss why discectomy and fusion is better option for the management of such cases. The complication rates, treatment satisfaction rates, visual analog scale (VAS) leg pain scores, and rates of adjacent segment disease (ASD) requiring surgery are similar in both the groups. However, the back pain score and reoperation rates are better in fusion surgeries. Moreover, the problems needing reoperations (hardware problems and ASD) in fusion group are easier to treat. Fusion surgery is already indicated in rLDH cases with deformity, instability, and significant axial low back pain. We believe it should be considered in all cases due to negligible risk of recurrence, addressing the iatrogenic spinal instability caused due to extensive bony work, ease of surgery due to more working space, and better restoration of disk height and sagittal balance.

Percutaneous vertebroplasty (PVP) is an “outpatient” procedure mainly used in osteoporotic vertebral fractures. This article aims to describe the author's technique and clinical results of PVP and also provides a broad overview of the pertinent literature focusing on the current status, controversies, and recent advances in the field of vertebral augmentation in the form of a narrative review.

Intramedullary spinal cord tumors are one of the most challenging neurosurgical conditions. The compact spinal cord fiber bundles (ascending and descending tracts) and spinal cord vascularity are at a huge risk during tumor resection. Hence, the resection of such tumors always has an inherent risk of inducing neurological deficits. Thus, the determination of tumor–cord interface assumes the greatest importance. The refinement in surgical technique and intraoperative neuromonitoring has increased the safety level of modern-day results with such tumors. Management of tumor recurrence and the exact role of adjuvant therapy, however, remains to be defined. In this review, we highlight surgically relevant aspects of these tumors, the current state of adjuvant treatment choices, and a literature review.

Objective: We performed this study to investigate the role of fixation by percutaneous pedicle screw fixation (PPSF) in spondylodiscitis secondary to TB origin for pain relief and rapid early mobilization of the patient. Material and Methods: Thirty-two cases of tuberculous spondylodiscitis were managed from March 2017 to 2019. Clinical assessment, radiological evaluation, and laboratory studies with over a year follow-up after PPSF without decompression. Visual analog scale (VAS score) and Oswestry disability indices (ODI scale, Hindi version) were used for outcome measure. Results: Female-to-male ratio was 19:13. The average follow-up was 14 months ± 6 days and the duration for fusion was around 6 months. The mean duration of hospital stay was 4.006 ± 1.17 days. The average blood loss was 27.18 ml ± 17.71. The mean surgical time was 121.25 ± 14.59 min. ATT was continued for 12–18 months. C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) pain scores (visual analog scale), and ODI were lower at 3 months and at final follow up. No failure of instrumentation or decline in neurological condition was reported after operative intervention. Conclusion: Primary treatment of TB spine has been chemotherapy with limited indications for surgery. Severe pain in the presence of spondylodiscitis without neurological deficit or deformity projects as an unclear situation and a temporary surgical fixation gives stability to prevent unexpected neurological injury and promote early healing with faster rehabilitation in contrast to strict bed rest and external bracing.

Mature spinal intramedullary teratomas are benign germ cell tumors that are associated with an excellent long-term outcome following early treatment with radical surgical resection. However, the preoperative diagnosis is often difficult and delayed due to their rare occurrence in the spinal cord, especially when the typical clinical and imaging features are not present. We report a case of intramedullary teratoma in a young adult female who presented with unusual clinical and preoperative radiographic findings. The final diagnosis was made on histopathological examination postoperatively. Variations in clinical presentations, imaging, optimal treatment strategies and histopathological characteristics of this rare tumor are discussed here with a review of the literature.

Ossification of the posterior longitudinal ligament (OPLL) is an uncommon spinal pathology. It can compress the spinal cord and result in a significant neurological deficit. Ossification of the ligamentum flavum (OLF) is a condition characterized by the formation of ectopic bone in the ligamentum flavum resulting in neurological impairment due to spinal cord compression. The coexistence of both these conditions is not frequently encountered. We present a unique case of a young male patient. He presented with weakness in both lower limbs, gait ataxia, and urinary symptoms due to spinal cord compression at lower dorsal and cervical levels due to OLF and OPLL, respectively.

Intraosseous schwannoma in the spine is a rare tumor. Complete resection is mandatory for avoiding recurrence in such cases. Resection followed by stabilization was very important in this case as the cervical vertebra was destroyed completely. Postsurgery patients had significant improvement in neurological symptoms.