Spinal tuberculosis is a relatively common form of extrapulmonary tuberculosis, mainly caused by the invasion of the vertebral body by Mycobacterium tuberculosis leading to destruction of the vertebral body and the formation of paravertebral abscesses, which can lead to paralysis in severe cases. Clinical manifestations include pain, weakness, localized masses, with or without hypothermia, night sweats, and in some patients, other symptoms such as cough and sputum. The main goal of surgical treatment for spinal tuberculosis is to completely remove the lesion, rebuild the stability of the vertebral body, and prevent spinal deformity; surgery is required to remove paravertebral abscesses, dead bone, and necrotic discs, and the surgical approach depends on the site and purpose of the surgery. The anterior approach is undoubtedly the first choice, which can fully reveal the paravertebral abscess, reveal the vertebral body and intervertebral disc from the lateral front, and remove the lesions under direct vision, while repairing and reconstructing the damaged vertebral body according to the characteristics of bone destruction. The posterior approach is to gradually reveal the anterior lesion through a front-to-back or lateral-to-posterior incision and then remove the lesion. The posterior approach has fewer important blood vessels and nerves on the surgical access and is less traumatic, but the surgical field of view is smaller and cannot fully reveal the damaged vertebral body, which can be considered for patients who cannot tolerate the anterior approach.