Case of spine fixation and decompression with vertebral body reconstruction:- A middle age female presented with severe low back pain, unable to turn and not able to walk and sit. Patient also complaining of severe right low limb radiculopathy. On MRI patient was diagnosed with severe osteoporosis with L4 compression fracture with neural compression. The purpose of surgery was to remove diseased vertebral bone and free the nerve root and also stabilization of spine. This was achieved with the help of mash cage and screws were fixed above and below with rod attached. Patient was sitting and walking next day of surgery with minimal pain.