Although various postoperative complications can occur after lumbar spine surgery, acute appendicitis remains relatively uncommon. Prompt identification and timely intervention for such complications are crucial for optimizing patient outcomes. A 55-year-old Persian woman with a body mass index of 35 kg/m2 presented with lower back pain radiating to her right leg. Magnetic resonance imaging revealed lumbar canal stenosis and L3–4 spondylolisthesis. She underwent an L3–4 laminectomy and transforaminal lumbar interbody fusion, which were completed without any immediate complications. However, postoperatively, she developed progressively worsening abdominal pain, necessitating exploratory laparotomy. This procedure identified acute appendicitis with a fecalith, requiring an appendectomy. This rare case underscores the importance of recognizing acute appendicitis as a potential complication following lumbar spine surgery, especially in obese patients. Early diagnosis and intervention are essential to achieve favorable outcomes. Reporting such cases helps raise awareness among healthcare professionals and contributes to evidence-based improvements in clinical practice.

Teratomas are benign germ cell tumors that usually found out of their anatomical origin. Teratomas usually are found in sacrococcygeal area, gonads, mediastinum, cervicofacial region and intracranial fossa. Spinal teratomas are rare. In this study we describe a case of conus medullaris teratoma which was diagnosed based on imaging studies. The patient underwent surgery. We did bilateral laminectomy. The mass lesion had an obvious and rigid attachment to the conus medullaris. The wall of the lesion was resected as much as possible, but total resection of the lesion’s wall could not be done due to changes in neural monitoring. Previous related studies are reviewed.