The patient was a male, 45 years old, who was admitted to the hospital with the main cause of lumbar pain for 6 months, aggravated with lower limb pain for 1 month. After admission, X-ray and CTMR showed destruction of the corresponding endplates of the 2-3 vertebrae of the lumbar spine, osteophytes, narrowing of the chase space, inflammatory changes of the intervertebral disc and vertebral body, and nerve root irritation by an abscess in the spinal canal: the patient was diagnosed as: lumbar spinal tuberculosis. After conservative treatment, the patient’s lumbar pain was not relieved significantly, so surgery was chosen. The patient’s paravertebral abscess was not serious, and posterior transvertebral foramen approach was chosen for lesion removal and internal fixation with bone grafting. Compared with the traditional posterior surgery, which caused large trauma to the stripping of the paravertebral muscles, the transvertebral foramen approach was entered through the longest muscle and the multifidus interval, avoiding muscle stripping and causing little trauma. The pain was relieved rapidly after the operation, and the patient could go down to the ground the day after the operation and recovered well.