Throughout his career Dr. Ramani has dedicated himself to the development of Spinal Surgery in India. His technique of Posterior Lumbar Interbody Fusion (PLIF) has been widely acclaimed & acknowledged. He has done over 1000 PLIF surgeries using his technique. Other surgical concepts in spinal surgery that he has developed are :-

• Microlumbar Discectomy,
• Discoplasty,
• Replacement of ligamentum flavum following discoidectomy,
• Neutralisation and bridge principle concept in the treatment of burst fractures
  in dorso lumbar injuries with or without neurological deficit,
• Internal de-compression of spinal stenosis (IDSS),
• Management of tabetic arthropathy in the spine,
• Transthoracic left sided approach to anterior dorsal spine,
• Extraperitoneal approach to lumbar spine,
• Transclavicular approach (right side) to anterior upper dorsal spine (D1 to D3)
  and sternal split approach to D4,
• Anterior approach to cervical spine always followed by fusion,
• Standard contoured Hartshill ring fixation and fusion of occiput,
• C1 & C2 instability at CV junction in Indian patients,
• Protocol for Arnold Chiary malformation,
• Protocol for Spinal Dysrrhaphism,
• Protocol for management of Kock's spine with or without neurological deficit