Keratoconus is a common late complication in patients with spinal tuberculosis who are prone to paraplegia due to long-term spinal cord compression. Therefore, patients with old tuberculous kyphosis should be operated on as early as possible to avoid late onset of paraplegia. The surgical treatment includes Smith-Peterson osteotomy (SPO), transverse pedicle osteotomy (PSO) and posterior segmental resection osteotomy (VCR), etc. Smith-Peterson osteotomy (SPO) has poor stability and is prone to nerve and vascular injury. The PSO, which closes the osteotomy gap, is more stable, but it can generally correct only about 40° of kyphosis. The combined anterior and posterior approach provides better orthopedic results, but requires at least two operations, is more invasive, and has a significantly higher complication rate. Posterior segmental resection osteotomy (VCR), by which the posterior convex segmental vertebrae are resected, can correct posterior convexity of more than 60°, and is currently the ideal method for treating severe posterior convexity.