Tuberculous and fungal osteomyelitis of the spine

Tuberculous, fungal, and other destructive spondylitic lesions must be accurately diagnosed to be treated. Diagnostic and treatment options have been outlined. Surgical management is dictated by (1) the presence or absence of neurologic deficit, (2) the extent and location of the destruction that affects the mechanical stability, (3) the need for diagnosis, and (4) the failure of nonoperative treatment. One should realize that conservative does not always mean nonoperative. It is conservative to decompress the spinal cord in spondylitic lesions when progressive paralysis exists.