In 1984, Kaneda first reported the use of anterior spinal fixation for stabilization in a fracture. Biomechanical comparision of Kaneda with posterior instrumentation after corpectomy model by Gurr et al. in 1988 showed that Kaneda device compared favorably with Cotrel-Dubousset and Steffe posterior systems, which require the incorporation of two or more motion segments. Another advantage of Kaneda device is that an additional posterior procedure is not needed. Harms et al studied the use of titanium mesh cages in the treatment of vertebral osteomyelitis and concluded that cages effectively reconstructs the anterior column, while adding stability and restoring the sagittal profile. There is no increase in the rate of recurrence or persistence of infection related to the implantation of titanium mesh cages. Case studies: Inconclusive X-ray of a 61-year-old lady pre­senting with severe neck and arm pain. Magnetic resonance imaging (MRI) shows destruction of the end plates at the C3-C4 end plates with abscess formation. The patient was reoperated, underwent complete corpectomy and reconstruction. She responded well, her 4 years follow-up X-rays shows good healing. 63-year-old lady presented with severe neck pain; MRI scan shows destruction of D1 vertebra. A 26-year-old man presented with back pain. The MRI scans show destruction at D11, D12 levels with abscess formation and kyphosis.27-year-old man with destructive lesion in L1-L2 vertebra presenting with severe unremitting pain in the back, despite being on AKT for 3 months.