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. The following diseases are also causes of anterior paravertebral soft tissue swelling or abscess: 1. Intervertebral disc calcinosis Intervertebral disc calcinosis in the spine is not uncommon in clinical practice, but is more frequent in the lumbar and thoracic spine; it is relatively rare in the cervical spine and is more common in children, so attention should be paid to this condition during cervical spine x-ray examinations in children. Because this disease can be self-healing, and the period of onset is short, and no trace is left on the X-ray plain film after healing, therefore, the actual onset of the disease is more than the clinical diagnosis, since the 1970s, the author has more than 100 cases of experience in the diagnosis and treatment. 2. Juvenile vertebral osteochondrosis Scheuermann’s disease is a rigid kyphosis (hunchback) deformity of the thoracic spine or thoracolumbar segment commonly seen in adolescents. Most children diagnosed before skeletal maturity can be successfully corrected with the use of braces. However, the disease is often confused with postural kyphosis and is not detected or diagnosed until after the onset of kyphotic deformity and persistent back pain, thus delaying the best time to prevent and treat it. Surgery is required when the deformity is severe, especially when non-surgical treatments fail to relieve the pain. Under normal circumstances, Seheuermann’s disease is a benign developmental disorder, with very few truly severe deformities and clinical symptoms. During the adolescent growth spurt, untreated Seheuermann’s disease can progress to progressive structural kyphosis, especially in those who have had trauma and overexertion during their growth spurt. The common back pain and fatigue often resolve spontaneously as the skeleton matures. If the eventual kyphosis does not exceed 75, the patient usually does not experience long-term discomfort except for back pain, which is often mild and rarely disabling. 3.Posterior bulge deformity of spinal tuberculosis Posterior bulge deformity of spinal tuberculosis is one of the serious sequelae, especially for children aged 10 years or older. It not only affects the appearance of the patient and the patient’s psychological pressure, but also affects the cardiopulmonary function of the thoracic spine or thoracolumbar tuberculosis posterior deformity in serious cases, and late onset focal healing paraplegia may occur. 4, spinal tuberculosis cold abscess penetrating into the cavity organs It is more common for spinal tuberculosis cold abscess to penetrate into the lungs, but less common for it to penetrate into the esophageal thoracic aorta and lumbar muscle abscess to penetrate into the cavity organs such as appendix, gallbladder, colon and bladder. For this reason, it is often misdiagnosed or missed in clinical practice. 5, spinal tuberculosis complicating paraplegia Spinal tuberculosis complicating paraplegia is due to a combination of cavity fluid, caseous material, dead bone or necrotic discs in the lesion, resulting in paraplegia. Sorrel and Sorrel-Dejerin (1925) referred to paraplegia as early onset paraplegia if it occurs within 2 years of spinal tuberculosis, and late onset paraplegia if it occurs after 2 years.