Abstract: Objective To explore the short-term and long-term effect of focal debridement and internal fixation of bone graft under different approaches in treatment of patients with single-segment lumbar tuberculosis. Methods A total of 54 patients with single-segment lumbar tuberculosis were divided into posterior approach group(n=29)and anterior approach group(n=25)according to different surgical approaches. The posterior approach group was treated with phase Ⅰ debridement and internal fixation of bone graft under posterior approach, while anterior approach group was treated with phase Ⅰ debridement and internal fixation of bone graft under anterior approach. The operation time, intra-operative bleeding volume and hospitalization time were compared between two groups. The erythrocyte sedimentation rates(ESR)and C reactive protein(CRP)level before and after operation were compared. The Visual Analogue Score(VAS)and Oswestry Index(ODI)of lumbago before operation and 12 months after operation were compared between the two groups. The incidence of complications at 12 months after operation were compared between two groups. Results The operation time, intra-operative hemorrhage and hospitalization time in the posterior approach group were significantly better than those in the anterior approach group(P<0.05). The levels of ESR and CRP in both groups decreased significantly(P<0.05), and the levels of ESR and CRP in the posterior - approach group were significantly lower than those in the anterior pathway group(P<0.05). The VAS and ODI scores in both groups significantly reduced after treatment(P<0.05), and the VAS and ODI scores of the posterior approach group were significantly lower than those of the anterior approach group(P<0.05). The incidence of postoperative complications in the posterior approach group was 10.34%, which was significantly lower than 32.00% in the anterior approach group(P<0.05). Conclusion Focal debridement and internal fixation of bone graft under posterior approach is effective and safe in treatment of patients with single-segment lumbar tuberculosis, which can effectively shorten operation time, reduce intra-operative blood loss and incidence of postoperative complications, and effectively improve short-term and long-term curative effect.