The authors have treated 50 cases of non specific spondylitis in adults and reviewed the clinical signs and diagnostic problems in this condition. They advocate a systematic surgical approach to the focus. This allows identification of the organism unless the patient has previously received antibiotics. Even then, a direct approach allows histological examinations to be made and necrotic and infected tissues to be cleaned up. In 12 highly destructive lesions, a bone graft was added. The results were more satisfactory when fusion across the disc was achieved. There were only two deaths.