1. Spine fusion is a safe and effective means of obtaining long-standing clinical and roentgenographic subsidence of disease in a large percentage of patients. The results are somewhat better in children.
2. To be most efficacious, spine fusion should be performed early in the course of the disease, before the development of major abscesses or of paraplegia, but it is still of great value and should not be withheld even after such complications have developed.
3. Failures are due to pseudarthroses or inadequate areas of fusion and also may occur in instances of marked virulence of the infecting organism or in overwhelming disease in individuals with low resistance.
4. Tuberculosis is a general disease of which the spine lesion is a local manifestation; this fact should not be overlooked in the treatment of the individual. Streptomycin and the newer isonicotinic acid hydrazides appear to have a beneficial effect on the disease itself, and also are of great adjuvant value in the treatment of the local lesion and its complications of sinuses and abscess formation.