Log in
General Surgery · CHAPTER 12. SPECIFIC SURGICAL INFECTION

Tuberculous spondylitis

Spondylitis tuberculosa

Tuberculous spondylitis is a specific spinal infection that is the most common form of skeletal tuberculosis. The disease proceeds in three consecutive phases, destroying the vertebral bodies and leading to severe orthopedic and neurological complications.

Ask the AI
LocalizationThe thoracic spine is most commonly affected, followed less frequently by the lumbar spine. From 2 to 4 vertebrae are typically involved.
Risk groupPrimarily affects young children.
DestructionFlattening of the vertebral bodies causes pathological compression fractures.
Cold abscessesPus spreads along fascial planes, descending into the iliac and inguinal regions.
2 min readFor medical studentsUpdated Sep 25, 2026
Material prepared by WhiteCoat Pro editorial team based on platform study guidesReviewed by medical editor: Aulov A. A., general practitioner · 09/24/2026

Prespondylitic phase

At this initial stage, the specific inflammatory process is completely hidden and localized strictly within the vertebral body.

  • Clinical presentation: Local spinal symptoms are absent. Signs of general tuberculous intoxication come to the forefront: the child loses weight (emaciation), refuses to eat, and becomes excessively irritable.
  • Laboratory diagnostics: Blood tests reveal lymphocytosis and an elevated ESR. The Mantoux test is positive.
  • Radiography: Of critical importance. On radiographs, the physician visualizes the primary focus of osteoporosis and areas of early bone tissue destruction isolated within the vertebra.

Spondylitic phase

The disease progresses: total destruction of the vertebral body occurs, with the infection spreading to the intervertebral discs and surrounding soft tissues.

  • Symptomatology: General intoxication persists. Pronounced pain appears, intensifying upon trunk flexion or pressure on the spinous process. Mobility is sharply restricted: to pick up an object from the floor, the child does not bend forward but is forced to squat while keeping the back straight.
  • Deformation: Spinal curvature develops. The spinous process of the destroyed vertebra protrudes, forming a gibbus.
  • Korney's rein sign: Upon attempting to extend the trunk, the back muscles tense into dense cords running from the angles of the scapulae to the affected segment.
  • Radiography: Destruction of the vertebral bodies is clearly visible—they are flattened, which is a sign of a pathological compression fracture. Shadows of cold abscesses are also defined.
Test your knowledge on this topicTasks from the "General Surgery" course bank — instant answers and explanations.

Complications of spondylitis

The spondylitic phase is dangerous due to the development of severe consequences:

  1. Cold abscesses: Purulent exudate spreads along muscle fascial planes (specifically along m. psoas major), forming cold abscesses in the iliac and inguinal regions.
  2. Purulent fistulae.
  3. Spinal cord compression: Occurs due to the displacement of destroyed vertebrae. Spinal cord compression leads to limb paralysis and pelvic organ dysfunction (urination and defecation problems).

Post-spondylitic phase

The final stage of the disease is characterized by the gradual subsiding of active inflammatory phenomena. However, clinical recovery is rarely complete: the patient may long retain previously formed cold abscesses, chronic fistulae, and persistent neurological deficits caused by previous spinal cord compression.

How to memorize

Korney's sign is easy to remember by association with "reins": when trying to straighten up, the back muscles tighten like reins running from the scapulae to the diseased vertebra.

Class and exam questions

Why does a child squat down rather than bend over to pick up a toy in spondylitis?

Due to the destruction of spinal structures in the spondylolytic phase, bending the torso causes severe pain. The child reflexively protects the back, keeping it straight and bending only at the knees.

How do cold abscesses form?

Pus during vertebral destruction does not stay in place, but descends along fascial sheaths (for example, along the psoas major muscle) and accumulates in the iliac or inguinal region.

What does vertebral flattening on a radiograph mean?

This is a sign of a pathological compression fracture: the vertebral body is destroyed by the tuberculosis process and subsides under the natural weight of the human body.

Something unclear? Ask the AIThe AI tutor has read the material on "Tuberculous spondylitis" and will explain it in simple terms.

What else to study on this topic

  • Mechanism of pathological compression fracture formation in tuberculosis
  • Topographic anatomy of the spread of cold abscesses along the fascia of the m. psoas major
  • Differential diagnosis of bone tuberculosis: epiphyseal and arthritic forms
  • Neurological consequences of spinal cord compression in spinal deformity
  • Interpretation of radiographs: foci of osteoporosis and cold abscess shadows

Master the entire topic in the "General Surgery" course

This is a summary. The course covers everything tested in classes and exams.

  • Complete study guide on "Tuberculous spondylitis" and 3,335 other subject pages
  • Assignments and quizzes after every topic — just like in a colloquium
  • AI tutor answers questions on the topic anytime
  • 70 video lessons on the subject
Open full reviewSubject curriculumfrom 599 ₽ per month

Other topics in «CHAPTER 12. SPECIFIC SURGICAL INFECTION»

Bone and joint tuberculosisTuberculous coxitis and gonitisTreatment of bone and joint tuberculosisTuberculous lymphadenitisActinomycosisAnthrax in surgery
The entire section «CHAPTER 12. SPECIFIC SURGICAL INFECTION»

Prepared by WhiteCoat Pro faculty in accordance with the medical school curriculum. For educational purposes only.