Spine is the most common form of skeletal Tuberculosis with the vertebral body being its preferred site. Spinal Tuberculosis may cause neurological damage, deformity. Predominantly, treatment is anti­tubercular drugs but surgery is required in instability with neurological compromise or deformity. There is a controversy regarding surgical approach to these lesions. Initially anterior approach was used to these lesions and now posterior approach is preferred by some authors. We present to you our operative experience of spinal tuberculosis from Craniovertebral junction (CVJ) to lumbosacral junction at our tertiary care referral centre. Our preferred approach was anterior to 55 of these lesions and 21 lesions were addressed by posterior approach in 70 patients. 67 of 70 (95.4) patients had improvement on follow up. Authors feel the good old anterior approach to predominantly anterior compressive lesions holds well in tuberculosis. More studies and longer follow up is required to analyse and compare anterior versus posterior approach.

Keywords: Spinal Tuberculosis; Anterior Approach; Posterior Approach; Surgery.