Disc herniation can regress, or even disappear, in a number of patients, rendering the radiological findings not to be taken as the only surgical indication criterium. We consider that the best treatment is the one relying on a good doctor-patient relationship, suspended in a balance between conservative and surgical treatment. According to clinical data, the first one (conservative) should not exceed the estimated time beyond which the surgical result would be unsatisfactory. The second one (operative), excepting "need-to operate" situations (such as cauda equina compression, progressive or serious motor déficit, or unbearable pain), should be prudently supedited to MRI regresión control, in particular in patients in which a clinical improvement is observed. Thus, the disc herniation conservative healing, both clinical as radiological, do exist, being a concept to widespread among clinicians and patients also.

The intravertebral injection of acrylic resin cement -usually polymethylmethacrylate (PMMA)- into a fractured vertebral body, constitutes the basis of the so called "vertebral augmentation techniques", "vertebroplasty" and "kyphoplasty", to manage pain and to strengthen and stabilize the compromised vertebra. In some ocassion, prior to the PMMA injection, an inflatable bone tamp was inserted into both pedicles of the fractured vertebra with the aim of restoring vertebral height to correct the kyphosis deformation. This procedure is called kyphoplasty (balloon-assisted vertebroplasty). The indications for vertebroplasty and kyphoplasty are evolving, from stabilization of painful osteoporotic vertebral fractures to vertebral collapse secondary to spinal metastases. In this paper we review the technical basis of both procedures, according to our experience in the treatment of vertebral fractures. Further studies are required to define the role for each technique in the spinal surgery's armamentarium.

As for complications, we registered three balloon disruptions and five leakages into the disc.Conclusions. Kyphoplasty could constitute an alternative and/or complementary treatment of traditional spinal stabilization-fusion procedures in non osteoporotic vertebral fractures. Therefore, it should be offered, when indicated, as a substantial possible part of the treatment, to the patients suffering from vertebral fractures. Additional advantages of combining kyphoplasty and posterior fusion are the possibility of reducing the number of fused levels (shorter instrumentations), and to perform a 360 degree stabilization-remodeling through a single posterior approach.

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ResumenIntroducción. Los ganglioneuromas o gangliomas son tumores de los ganglios simpáticos que contienen células de la cresta neural, pudiendo aparecer en cualquier parte del organismo. Son generalmente benignos, más frecuente entre los 10 y los 40 años, pueden secretar hormonas y, en ocasiones, asociarse a trastornos genéticos, como la neurofibromatosis tipo I.Objetivo. Revisar la literatura científica relacionada con el tema y presentar un caso tratado en nuestro servicio.Discusión. La sintomatología de estas lesiones depende de su ubicación y de las sustancias vasoactivas que puedan secretar. A pesar de que son tumores benignos en su mayoría, en ocasiones pueden metastatizar. Las pruebas de imagen y de laboratorio son inespecíficas, por lo que el diagnóstico definitivo es anatomopatológico. En los casos sintomáticos el tratamiento de elección es la resección quirúrgica.Conclusión. La asociación de un ganglioneuroma y de una hernia discal lumbar es algo excepcional. El tratamiento requiere su resección quirúrgica.PALABRAS CLAVE. Ganglioneuroma. Ganglioma. Hernia discal. Ganglioneuroma coinciding with a lumbar disk herniation SummaryIntroduction. Ganglioneuromas or gangliomas are tumours of the sympathetic ganglia that contain cells of the neural crest, so they can appear in all body localizations. They are generally benign, more frequent between 10 and 40 years, may secrete hormones and, sometimes, Neurofibromatosis type I and other genetic disorders can be associated.