Introduction: Kummell disease is a condition characterized by severe pain, progressing kyphosis with or without neurological deficit following a trivial trauma in the old age osteoporotic population. It is an osteoporotic vertebral fracture due to avascular necrosis of the vertebra, having an asymptomatic period initially followed by progressive pain, kyphosis, and neurologic deficit. Although various management options are available for Kummell’s disease, a dilemma occurs in selecting an optimal modality in each case. Case Report: A 65-year-old female presented with complaints of low back pain for 4 weeks. She developed progressive weakness and bowel bladder disturbance. Radiographs showed a D12 vertebral compression fracture with an intravertebral vacuum cleft sign. Magnetic resonance imaging showed intravertebral fluid and significant compression of the cord. We performed posterior decompression, stabilization, and transpedicular bone grafting at the D12 level. Histopathology confirmed Kummell’s disease. The patient recovered with restored power and bladder control and resumed independent ambulation. Conclusion: Osteoporotic compression fractures are more prone to pseudoarthrosis due to poor vascular and mechanical support, they need adequate immobilization and bracing. Transpedicular bone grafting for kummels disease seems to be a good surgical option due to its short operating time, less bleeding, less invasive approach, and early recovery. However, a treatment-oriented classification is needed to treat this clinical entity on a case-by-case basis. Keywords: Kummell’s disease, osteoporosis, kyphoplasty, transpedicular bone grafting, spine.

Introduction: : Spinal hemangioma is the most common benign lesion of the spine with an incidence of 10–12%. Aggressive hemangioma presents with back pain, deformity, or neurologic deficit. Aggressive hemangioma presenting as painful scoliosis is very rare and literature reporting them is very limited. Case Report: We present the case of a boy in his second decade who presented with back pain for 1 month radiating to his right chest with a deformity in his back. MRI showed a hyperintense lesion involving the sixth dorsal vertebra in the T2-weighted image and a hypointense lesion with striations in STIR images suggestive of hemangioma. Pre-operative embolization was done using micro platinum coils. The patient underwent a decompressive laminectomy and vertebral body decompression. The patient also underwent 12 cycles of adiotherapy. The patient had complete resolution of the deformity without any recurrence at 2 years. Conclusion: Management of aggressive hemangiomas with neurologic deficit needs a multidisciplinary approach with surgery, pre-operative embolization, and post-operative radiotherapy. Keywords: Adolescent scoliosis, spinal hemangioma, laminectomy, embolization, scoliosis