Background: Tuberculous spondylitis remains a significant cause of morbidity in the Philippines, with limited local outcome data.

Objective: To describe the demographic profile, clinical characteristics, management, and outcomes of patients with tuberculous spondylitis treated at a tertiary level medical center from 2015–2024.

Methodology: 10-year retrospective chart review patients diagnosed with tuberculous spondylitis. Demographic, clinical, radiographic, and management data were collected and analyzed.

Result: A total of 69 patients were included. Male patients comprised 63.6%, and 63.6% were unemployed. The mean age was 40 years (range, 19-59). Thoracic involvement was reported in 59% of cases. Back pain was reported in 48.5%, and neurologic deficits were reported in 27.3%. On neurologic assessment at presentation, 50% had incomplete neurologic deficits and 10.6 % had complete deficits. Management consisted of anti-tuberculous therapy alone in 59.1% and anti-tuberculous with bracing in 21.2%. Thirteen patients (19.7%) underwent surgery, all via a posterior approach. In the surgical cohort, the mean preoperative kyphosis angle was 47.7 degrees (range, 39 – 79 degrees), and the mean postoperative kyphosis angle was 40.8 degrees (range, 27-55 degrees). Neurologic recovery was documented among patients with incomplete deficits. The mean interval from surgery to discharge was 51 days. At 2 years, more than 90% of patients were lost to follow-up.

Conclusion: Tuberculous spondylitis in this cohort was observed predominantly among unemployed young to middle-aged males, with thoracic spine involvement and a substantial proportion presenting with neurologic compromise. Among surgically treated patients, posterior surgery was associated with modest deformity correction and neurologic improvement during the early postoperative period. Long-term outcomes could not be reliably assessed due to >90% loss to follow-up at 2 years. Strengthened early detection, improved continuity of care, and inclusion of functional outcomes in future studies are recommended.