[Objective] To compare the clinical efficacy of posterior fixation with anterior titanium plate fixation for single-segment thoracolumbar (T10-L2) tuberculosis. [Methods] 43 cases of single-segment thoracolumbar tuberculosis admitted to the First Affiliated Hospital of Guangxi Medical University from July 2010 to July 2017 were selected, among which 22 cases received lateral anterior approach titanium cage titanium plate fixation (group A) and 21 cases received posterior approach nail bar fixation (group B).Group B was divided into two subgroups according to whether bone grafting was performed: group B1 (12 cases) was the bone grafting group, and group B2 (9 cases) was the non-bone grafting group. The operative time, postoperative blood loss, Frankel classification, Visual analogue scale (VAS) score, Cobb Angle change and complications in the three groups were compared and analyzed. The postoperative deformity correction rate and the degree of correction Angle loss in each group were calculated and statistically analyzed. [Results] All 43 patients were followed up for 2-9 years, and all patients had fusion of bone graft or intervertebral fusion. There was no significant difference in intraoperative blood loss, hospital stay and bone fusion time between the three groups (P>0.05).VAS score and Frankel grading in all three groups were improved compared with that before surgery (P<0.05), but the difference between the groups was not statistically significant (P>0.05).The operation time of group B1 and group B2 was less than that of group A (P<0.05), but the difference between group B1 and group B2 was not statistically significant (P>0.05).The correction rate of posterior malformations in group B1 and B2 was better than that in group A (P<0.05), and the degree of correction Angle loss in group A was greater than that in group B1 and B2 (P<0.05). [Conclusion] On the premise of strictly grasp the operation indication, posterior screw rod fixation with titanium plate fixation in front side are single segmental thoracic lumbar tuberculosis can be effectively treated, but the former operation in time, orthopedic effect and spinal stability has a certain advantage, and which are available for bone graft or not between vertebral osseous fusion effect.