Tuberculosis of the spine and metastases of the spine are two different diseases, both with lesions in the spine, but there are still some points of distinction between them. Tuberculosis of the spine is an infectious lesion caused by Mycobacterium tuberculosis. Spinal metastases are metastatic lesions caused by various cancers, such as lung cancer, prostate cancer, breast cancer, kidney cancer, etc., that metastasize to the spine. Tuberculosis is commonly understood to be a bacterium that devours and destroys all structures it can touch. At this time, the tumor is specific and invades the bone tissue. Because of the difference between the two, the biggest point of differentiation is in imaging, because in spinal tuberculosis, after the tubercle bacillus has invaded all structures, the vertebral space is narrowed and can destroy the vertebral plate and body, forming an abscess. In spinal tumors, the damage is limited to the bones and the height of the intervertebral space is unchanged, and the intervertebral space is not narrowed, which is a very important differentiating point in imaging. The biopsy of the vertebral body can be used to obtain the lesion tissue directly, so that a more intuitive identification can be made to see if it is tuberculosis, if there is caseous necrosis or tumor, and if the cancer cells of the primary focus are induced.