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Spinal tuberculosis characteristically involves two contiguous vertebral bodies with narrowing of the disk space. We report on 11 children with atypical spinal tuberculosis. Three had disease confined to a single body, four had extradural extraosseous involvement presenting as an abscess, and isolated infection of the neural arch was seen in four children. Seven children had neurological involvement. Treatment included posterior decompression for the extradural extraosseous involvement, biopsy and drainage for the neural arch infection, and anterior decompression and fusion for the single-body disease. The patients had antituberculosis treatment for 18 months, and all seven children with neurological involvement recovered.