Tuberculous spondylitis shows a natural attempt toward spinal fixation by hypertrophic bone changes in at least ten per cent. of cases.
This natural attempt toward spinal fixation by bony bridging is most likely to occur in that portion of the spine in which there is the greatest freedom of movement, i.e., the lumbar region.
Bony ankylosis of the spine may occur in tuberculous spondylitis without the presence of a mixed infection.
It is possible that many cases of spondylitis, diagnosed monarticular osteoarthritis, are of tuberculous origin.
This condition has not been found, except in those who have attained adult age.
Since spinal fixation has long been considered the most rational treatment for tuberculous spondylitis, and since bony fixation occurs naturally in a certain percentage of cases, it would seem justifiable to recommend internal fixation by bone graft or spinal fusion as a most rational aid toward recovery, especially in the adult.