【Abstract】Objective To explore the clinical effect of posterior surgery for the treatment of spinal suppurative osteomyelitis in the thoracolumbar fracture site. Methods A retrospective analysis of 5 cases about the diagnosis, treatment and follow-up data of patients with non-specific suppurative spinal osteomyelitis in the fracture site of the thoracolumbar vertebral compression fractures from January 2010 to December 2017 in our department, including 3 males and 2 females, All patients underwent non-surgical treatment after injury,the age of 52 to 76 years old with an average of 64.8 years old. After the fracture to the onset time of infection, it is 1.2-3.5 (2.7±1.2) months. The biopsy and bacterial culture susceptibility test was performed before and after surgery, and all pathological examinations were positive. All the 5 patients underwent posterior debridement, bone graft fusion and internal fixation, and antibiotics were applied for 6-9 weeks. Comparison of visual analogue scale score (VAS), ASIA neurological function score, white blood cell count (WBC), erythrocyte sedimentation rate (ESR), reactive responsive protein (CRP), imaging examination (reactive pmtein, CRP) The kyphosis Cobb angle, fusion rate) and other conditions were evaluated for its efficacy. Results All the 5 patients underwent surgery successfully. The operation time was 125-165 min, with an average of (145±14.8) min. The average blood loss was 150-350 ml, with an average of (179.1±52.2) ml. The wound healed in the first stage. The pre-treatment VAS score was (9.1±0.88) points, after 1 week of operation the score was (2.5±1.2) points. The VAS score was (1.6±1.1) points at the last follow-up. The improvement rate was 93%, The difference was statistically significant. After 1 week, the pain symptoms of all patients were postoperatively relieved, and the white blood cell count, erythrocyte sedimentation rate, and C-reactive protein decreased significantly, and fell to normal after 4-6 weeks. The results of bacterial culture and drug susceptibility test showed: 3 cases (60%, 3/5) were Staphylococcus aureus in Gram-positive bacteria; 1 case (20%, 1/5) was methicillin-resistant Staphylococcus aureus; 1 case was negative (20%, 1/5). The anterior and posterior convex Cobb angle was 21.5°～42.6° (29.2°±6.59°); the postoperative convex Cobb angle was 7.2°～13.6°(average 10.2°±2.0°); the correction rate was 66.36%; At the time of follow-up, the Cobb angle of the kyphosis was 8.3°～14.2° (average 11.4°±4.6°), and the Cobb angle loss was 0.8°±0.3°. There were significant differences in Cobb angle between the postoperative and the last follow-up (P＜0.05). According to the Eck fusion grading standard, the fusion rate reached 100% after 12 months. This group of patients had no relevant surgical complications and no recurrence. Conclusion 1.The diagnosis of suppurative spinal osteomyelitis in the secondary fracture site after thoracolumbar fracture is difficult, which is easy to be misdiagnosed and has a long course；The vertebral body is heavier and has different degrees of kyphosis. 3. One-stage posterior debridement and bone graft fusion and internal fixation and standard antibiotic treatment can achieve good therapeutic effect.