Spinal tuberculosis and brucellosis spondylitis are both idiopathic infections, and drug treatment is the most critical. However, for patients with severe localized pain, spinal instability, deformity, and spinal cord or nerve compression symptoms, surgical treatment is required.The TLIF procedure is widely used in the treatment of paracentral or extreme lateral lumbar disc herniation and lateral lumbar stenosis, and it is less invasive than PLIF interbody fusion, with less irritation of the nerve roots. In view of the advantages of this procedure and the updating of the concept of spinal tuberculosis surgical treatment, TLIF surgery is now advocated for the treatment of single-space lesions in which the extent of dead bone and abscess is not large and the vertebral destruction is not severe. Traditional TLIF surgery requires extensive stripping of the paravertebral muscles to fully expose the articular process to complete interbody fusion through the intervertebral foramina, and the extensive stripping of the soft tissues and prolonged strong pulling during the surgery can lead to denervation of the paravertebral muscles. The modified TLIF procedure has been changed to a channel-assisted transforaminal approach, which eliminates the need for extensive stripping of the paravertebral muscles and therefore significantly reduces muscle injury and the incidence of postoperative low back pain. However, both modified TLIF and traditional TLIF surgery for lumbar tuberculosis require resection of the articular synovial joints, which can affect the mechanical stability of the spine, and can lead to the lesion communicating with the spinal canal, resulting in postoperative adhesions to the dura mater, nerve roots, and the possibility of sinusoidal tract formation toward the posterior.In 2002, Phillips used the transverse intertransversal Wiltse approach to perform a very lateral herniated disc nucleus pulposus In 2002, Phillips used the transverse Wiltse approach for extreme lateral disc herniated nucleus pulposus removal and interbody fusion, and called it ILIF (intertransverse lumbar interbody fusion). The differences in postoperative complications and other aspects of the clinical data are reported as follows: Data and Methods 1. General data: from August 2010 to August 2013, we used ILIF to treat 38 cases of lumbar tuberculosis and brucellosis spondylitis, of which 34 patients were followed up, 19 males and 15 females; the age ranged from 18 to 59 years old, with an average of 34.7 years old. Previously, we used conventional TLIF surgery to treat 39 such patients, and 31 of them received follow-up, including 17 males and 14 females; their ages ranged from 19 to 62 years old, with an average of 35.1 years old. All patients had single-segment lesions with predominantly low back pain, no nerve compression symptoms, and the lesions were confined to the intervertebral space and adjacent vertebral endplates. The distribution of lesion sites is shown in Table 1.The diagnosis of lumbar brucellosis spondylitis was based on the criteria established by Tekk?k et al [5], i.e., the diagnosis was confirmed by meeting 2 or more of the following criteria: (1) positive blood culture or bone marrow aspiration culture; (2) standard brucellosis agglutination test with an antibody titer ≥ 1:160; (3) confirmation of spinal involvement by X-ray, CT, or bone scan; and (4) pathologic findings confirming non tuberculous granulation tissue. 2.Pre-operative preparation: after admission to the hospital, relevant departments were invited to consult and treat the combined diseases. Lumbar spine tuberculosis is treated with conventional four combinations of anti-tuberculosis drugs (isoniazid, rifampicin, pyrazinamide, ethambutol) and active nutritional supportive therapy for 2-4 weeks, and surgery is performed when tuberculosis toxicity symptom is reduced and the erythrocyte sedimendation rate (ESR) is <60 mm/ h or tends to decrease. Lumbar brucellosis spondylitis preoperative oral doxycycline 0.1 g, 1 time / d, the first dose doubled, rifampicin 0.45 g, 1 time / d, for 2 weeks after surgery. Surgical methods: (1) ILIF procedure The patient was put under general anesthesia by tracheal intubation and lay prone on the position frame. A longitudinal incision was made from the upper edge of the normal vertebral spinous processes adjacent to the proximal end of the diseased segment to the upper edge of the normal vertebral spinous processes adjacent to the distal end of the diseased segment. The skin and subcutaneous tissues were incised, and the lumbar dorsal fascia was incised 2-3 cm adjacent to the spinous processes, and the multifidus muscle and the longest muscle space were bluntly separated to reveal the articular synchondrosis. A connecting rod was installed on the less damaged side, and the joint was immobilized after being moderately supported. The intertransverse ligament was cut on the severely damaged side of the lesion, and the nerve roots were retracted proximally and anteriorly by bluntly separating them from the outer edge of the articular synovial joint of the diseased segment and the upper edge of the pedicle of the distal diseased vertebral body to expose the Kambin's triangle of safety proximally and anteriorly [6]. Due to the inflammatory reaction of the lesion interspace abscess, local adhesions are often present, and the lateral portion of the articular eminence joint may be appropriately resected in order to facilitate adequate visualization of the safety triangle. The fibrous annulus of the intervertebral disc is incised, and the necrotic disc, abscess, granulation tissue and dead bone in the intervertebral space are thoroughly removed. After repeated rinsing, 2 g of streptomycin powder was inserted, and according to the height of the intervertebral space, a three-sided cortical autogenous iliac bone block was implanted into the intervertebral space as a supporting implant. The contralateral temporarily braced nail-rod connection was loosened, and the ipsilateral connecting rod was installed at the same time. After moderate compression of the intervertebral space, the nail-rod connection was tightened, and the incision was closed after placing a drain. (2) TLIF procedure The patient is placed prone in a position frame under general anesthesia by endotracheal intubation. A longitudinal incision was made from the superior margin of the normal vertebral spinous processes adjacent to the proximal end of the diseased segment to the superior margin of the normal vertebral spinous processes adjacent to the distal end of the diseased segment. The skin and subcutaneous tissues were incised, and the lumbar dorsal fascia was incised 2-3 cm adjacent to the spinous processes on the lighter side of the lesion to bluntly separate the multifidus muscle and the longest muscular space to reveal the articular synovial joint. The pedicle was inserted into the vertebral body of the diseased segment. If the destruction of the diseased vertebral body was aggravated, the fixed segment could be extended appropriately, and the connecting rods could be installed and moderately spread out for posterior fixation. On the severely damaged side of the lesion, the erector spinae muscle is peeled off, the articular synovial joint is exposed and excised, and the fibrous annulus of the intervertebral disc is exposed and incised through the intervertebral foramen to remove the necrotic discs, abscesses, granulation tissues, and dead bones in the intervertebral space thoroughly. After repeated rinsing, 2 g of streptomycin powder was inserted, and according to the height of the intervertebral space, a three-sided cortical autogenous iliac bone block was implanted into the intervertebral space to support the bone graft. The contralateral temporarily braced nail-rod connection was loosened, and the ipsilateral connecting rod was installed at the same time. After moderate compression of the intervertebral space, the nail-rod connection was tightened, and the incision was closed after placing drainage. (3) Postoperative management: Patients with lumbar spine tuberculosis were treated with a standard chemotherapy regimen of anti-tuberculosis drugs (3HRZE/9HRE) after surgery, i.e., isoniazid, rifampicin, pyrazinamide, and ethambutol were given orally for 3 months, after which pyrazinamide was discontinued, and the other drugs continued to be given orally for 9 months. Patients with lumbar brucellosis spondylitis continued to apply doxycycline and rifampin for 8 to 12 weeks after surgery. Patients wore a brace to get out of bed 3 to 7 days after surgery, and the brace was worn for 3 months. Postoperative follow-up ranged from 12 to 36 months, with an average of 22 months. 3, Statistical processing The data were expressed using the application of SPSS13.0 statistical software (SPSS Inc., USA), preoperative, 7 days postoperative, and the last follow-up VAS, ODI scores were analyzed by ANOVA, t-test was used for comparison between the two groups, and chi-square test was used for the comparison of the rate of complications between the two groups, with P<0.01< span=""> as the difference was statistically significant. Results The difference between the two groups was not statistically significant when comparing the operation time and intraoperative bleeding. The differences between the two groups were statistically significant when comparing the VAS and ODI scores at 7 days postoperatively and at the final follow-up with the preoperative period (p<0.01< span="">), and the differences were statistically significant when comparing the VAS and ODI scores at 7 days postoperatively between the two groups (p<0.01< span="">) but the differences were not statistically significant when comparing the patients at the final follow-up (p>0.05). ilif group Transient nerve root pulling pain occurred in 6 cases after surgery: 1 case of lumbar 2 nerve root, 3 cases of lumbar 3 nerve root and 2 cases of lumbar 4 nerve root, which were treated with dehydration and neurotrophic therapy, and the symptoms disappeared after 2-8 weeks; only 1 patient in the TLIF group developed symptoms of transient nerve root pulling pain, which was in lumbar 4 nerve root, and the symptoms disappeared after 1 week, but the difference was not statistically significant when comparing between the two groups (p>0.05).The TLIF Four patients formed temporary sinus tracts after surgery in the group, and only one in the ILIF group, but the difference was not statistically different (p>0.05). The difference in time to implant fusion and incidence of pain in the donor area between the two groups was not statistically different (p>0.05).