Primary and important treatments in TB spine is antitubercular drugs. So TB per se has to be managed by antitubercular drugs which is effective if taken under any clinical supervision for long time. Second thing is TB spine being very near to the nerves and cause secondary effects lie compression of the nerve roots, or spinal cord and that can be managed by the pathology as to how many segments are involved or if it is stable or unstable one. If it is unstable one then surgical intervention may be required to stabilize the vertebral segments, to avoid further neurological insult, till the TB pathology healed. Or if it is totally stable, it can be managed conservatively till the drugs take over and completely heals the TB pathology without any neurological complaints. If the patient is on antitubercular drugs and the patient develops new neurological complication, the also a surgical intervention might be required. Main stay is anti-tubercular drugs. Secondary manifestation of TB spine has to be managed on an individual basis

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