Anterior and paravertebral soft tissue swelling or abscesses are one of the important features in the diagnosis and differential diagnosis of spinal tuberculosis, and in particular, calcification of abscesses is often specific. Anterior paravertebral soft tissue swelling or abscesses are commonly seen in cases of spinal tuberculosis with extensive and severe destruction of the vertebral body and adnexa. Spinal tuberculosis accounts for about 50% of bone tuberculosis and is more prevalent than extremity joint tuberculosis. The vast majority of spinal tuberculosis is vertebral tuberculosis, accounting for more than 99% of cases, and adnexal tuberculosis accounts for less than 1%. The high incidence of vertebral tuberculosis is determined by the physiological anatomy of the spine: (1) the entire spine has 23 movable vertebrae, with a large number of vertebrae; (2) the spine is the central axis of the human torso, and the vertebrae are heavily loaded with strain; they have few muscle attachments and many cancellous bone components. Because TB bacilli are easy to stay and multiply in areas with slow blood flow and high strain, they are easy to “settle” in vertebral areas. At the same time, the vertebral nutrient artery is the terminal artery, which is easily blocked by bacterial infection, resulting in inadequate blood supply to the diseased vertebrae, reduced resistance to disease, and the formation of tuberculosis lesions. Patients are mostly under 30 years of age, accounting for about 73%. Adult lesions tend to occur at the upper and lower edges of the vertebral body, with osteolytic destruction dominating and causing narrowing of the vertebral space. Compression of the diseased vertebral body can lead to pathological compression fractures and even high level paraplegia in severe cases. Spinal tuberculosis is difficult to diagnose because of its deep location and early symptoms are not obvious. The following manifestations should be noticed: low fever in the afternoon, loss of appetite, emaciation, night sweats, and fatigue and weakness. Pain is usually the first symptom to appear, mostly mild dull pain, light at rest, heavy when exerting, aggravated when coughing, sneezing or carrying things. Some patients have pain at night and in the morning, which is relieved or disappears after activity and walking. If the lesion compresses the spinal cord and nerve roots, the pain may be quite intense and radiates along the nerve roots. Visually, people with spinal tuberculosis often have muscle spasms, postural abnormalities, and limited motion. Patients with cervical tuberculosis often have an oblique neck deformity, head tilted forward, and difficulty moving: patients with thoracic and lumbar tuberculosis cannot bend over to pick up objects, but can only awkwardly and mechanically bend their hips, bend their knees, squat with their backs, support their thighs with one hand, and pick things off the floor with the other. Patients initially diagnosed with spinal tuberculosis should undergo routine X-ray examinations to detect abnormalities in the physiological curvature of the spine, changes in the shape of the vertebral body and the vertebral space and soft tissues surrounding the vertebral body. CT and MRI can also be performed to show the extent and degree of vertebral destruction, the size and location of the dead bone, and whether the vertebral space is narrowed or missing.