Tuberculosis (TB) is one of the world’s most persistent diseases. With the expansion of human activities and the indiscriminate use of drugs, TB, which was once under control, has become active again and is more difficult to treat clinically with drugs. If tuberculosis occurs in the spine, it causes bone destruction of the vertebral body and also causes disc herniation, resulting in posterior protrusion of the spine (commonly known as hunchback) and collapse of the vertebral space, which can lead to paralysis if nerves are compressed. With the development of minimally invasive technology, it is now possible for patients with spinal tuberculosis to have the lesion removed through spinal endoscopy. This has dramatically changed the previous treatment paradigm and reduced the trauma to the patient. For spinal TB with poor spinal stability and nerve compression, surgery is an important way to solve the problem. Surgery can remove the dead bone, rebuild the stability of the spine, and prevent nerve and medullary compression. Here is the case we did. Of course, surgery is the solution to the problem of dead bone and abscesses, but it is not the whole story! The most and most fundamental thing is anti-tuberculosis treatment! Since Mycobacterium tuberculosis is very stubborn, early, full, appropriate, regular, and combined medication is the key! Toxic side effects of drugs need to be reviewed regularly, in addition, it is also important to enhance nutrition!