Tuberculosis of the spine is a very common clinical disease that causes damage to the vertebrae due to Mycobacterium tuberculosis. The disease is mostly secondary to pulmonary tuberculosis and is more common in children, with the incidence decreasing significantly over the age of 30. Due to the collapse of the vertebrae, the accumulation of tuberculous pus in the vertebral canal and spinal canal, and the formation of granulation tissue, the spinal cord can be involved, resulting in paraplegia due to spinal cord compression, and in severe cases, the spinal vertebrae can collapse and deform the spine. It has a serious impact on the confidence and life of the patient. The lesions are mostly found in the thoracic spine, with T10-T12 and the lumbar spine being the most common. First, the manifestation and imaging examination of spinal tuberculosis 1, bone and joint changes on X-ray film is dominated by bone destruction and spinal space narrowing. Repeat radiographs or other examinations are required for suspicious cases. In the central type, the bone destruction is concentrated in the central part of the vertebral body, which is clearer in the lateral view. The vertebral body soon appears to be compressed into a wedge shape, narrowing anteriorly and widening posteriorly. It can also invade the intervertebral discs and involve the adjacent vertebral bodies. In the marginal type, the bone destruction is concentrated at the upper or lower edge of the vertebral body and soon invades the intervertebral disc, showing destruction of the vertebral end plate and progressive intervertebral space narrowing, and involving the two adjacent vertebral bodies. 2, cold abscess manifestation: abscesses are formed after the invasion of tissues by tuberculosis bacteria, which usually occlude the surrounding microcirculation without abundant blood supply because the tuberculosis bacteria survive in an anaerobic environment. In contrast, general bacterial abscesses open microcirculation under the action of inflammatory mediators and manifest as local fever, redness and swelling. Tuberculous abscess differs from abscesses formed by general bacterial infection in that the pathological basis is the occlusion of the peripheral vessels by the action of tuberculosis toxins, which manifests as an abscess without fever, commonly known as a cold abscess or a chilling abscess. On a lateral cervical spine film, it appears as a widened anterior soft tissue shadow and anterior displacement of the trachea; on a thoracic spine orthopantomograph, a widened paravertebral soft tissue shadow is seen, which may be spherical, spindle-shaped or cylindrical, and is generally not symmetrical. In lumbar orthopantomographs, abscesses of the psoas major muscle may appear as blurring of the shadow of the psoas major muscle on one side, or as widening, fullness or limited elevation of the psoas major muscle shadow, and the abscess may even flow into the hip and femoral triangle. In chronic cases, multiple calcified shadows can be seen. 3.CT examination can clearly show the site of the lesion, and cavity and dead bone formation can be seen. Even small paravertebral abscesses can be detected during CT examination. ct examination is uniquely valuable in detecting abscesses of the psoas major muscle. It shows deformation of the spinal canal and spinal cord compression. 4. MRI (magnetic resonance imaging) examination is not only of early diagnostic value, showing abnormal signals at the stage of inflammatory infiltration, but also can be used to clarify the compression of the spinal cord, and the degenerative necrosis of the spinal cord itself. It is also possible to observe the course and distribution of cold abscesses. Second, the treatment of spinal tuberculosis 1, drug therapy and supportive therapy according to the presence or absence of surgical indications to decide whether to operate. Even if surgery is indicated, 2 to 4 weeks of drug and supportive therapy is required as preoperative preparation. This includes systemic antituberculosis drug therapy and local braking. Generally, the combination of two anti-tuberculosis drugs is used, and the treatment is changed to a single anti-tuberculosis drug after 3-6 months, and the whole course of treatment should be no less than 2 years. At the same time, nutritional support therapy and braking treatment with external brace are given. 2.Surgical treatment (1)Incision and drainage of pus. When a cold abscess is widely injected and causes secondary infection, the patient has obvious symptoms of systemic toxicity and cannot tolerate lesion removal, incision and drainage can be done to save life. After the cold abscess is incised, the systemic toxic symptoms are expected to be controlled and sinus tracts are easily formed. (2) Focal debridement. from the 1940s to 1950s, the successful synthesis and extraction of anti-tuberculosis drugs provided the conditions for the implementation of focal debridement. (3) Focal debridement combined with spinal fixation and fusion. The combined application of posterior pedicle screw system and anterior lesion removal surgery can enhance spinal stability and enable patients to get out of bed early. (4) Combined spinal deformities require surgical orthopedic treatment. (5) Combined spinal cord damage or incomplete paralysis requires early surgery to release spinal cord compression and save the function of the spinal cord to avoid the formation of spinal cord necrosis and irreversible damage resulting in permanent paraplegia.