Whether or not surgery is used to treat spinal tuberculosis, drug therapy for tuberculosis is a required treatment both preoperatively and postoperatively. Isoniazid, rifampin, pyrazinamide, and ethambutol are the four drugs most commonly used for treatment. Isoniazid and rifampin are full bactericidal agents, pyrazinamide is a semi-bactericidal agent, and ethambutol is a bacteriostatic agent. It is usually safer to take these four anti-tuberculosis drugs orally plus levofloxacin for 2 weeks of intensive treatment before surgery. After surgery, oral anti-tuberculosis drugs are required for 18 months. During this period, the liver and kidney functions need to be reviewed monthly, and if liver function is impaired, liver protection therapy is required and anti-tuberculosis drugs need to be changed if necessary. Alcohol consumption is strictly prohibited during the drug administration period to prevent liver damage. Short-course drug therapy is available, but it is prone to relapse of tuberculosis and to induce drug resistance of tuberculosis bacteria, so not many doctors use short-course anti-tuberculosis therapy. More doctors are using long course anti-tuberculosis treatment to ensure the efficacy of treatment. In the past 10 years, we have been treating about 100-140 cases of spinal tuberculosis per year with a long-course regimen, with no cases of tuberculosis resistance, and 99% of patients are cured. Most of the relapse cases are related to patients not taking tuberculosis drugs regularly after surgery, short treatment time; or incomplete removal of the lesion during surgery.