Between October 1968-1973, 16 rachitomies were carried out in 14 patients at the Univ. of Orthop. Hospital Balgrist in Zurich. The casuistic indicates the necessity for diagnostic surgery, particularly because tuberculous spondylitis cannot be differentiated radiologically from other nonspecific processes. Rachitomy together with histologic and bacteriologic examinations of precisely removed specimens makes a dependable diagnosis possible and permits therapeutic accommodation of the procedures to the individual case as 15 out of 16 of our cases indicate. The direct therapeutic possibilities and the diagnostic accuracy document, in our opinion, the superiority of rachitomy over exploratory puncture. Following-up control examinations up to four years following the operation confirm the success of surgery as evaluated by the subjective freedom of complaints and satisfactory results.