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