Objective To evaluate the feasibility and clinical efficacy of Treatment of thoracolumbar tuberculosis kyphosis deformity in active stage by posterior-only column shortening, focal debridement and titanium mesh bone grafting. Methods The clinical data of 25 patients with active thoracolumbar tuberculosis with kyphotic deformity admitted to our hospital from January 2010 to December 2016 was retrospectively analyzed. All cases underwent treatment of thoracolumbar tuberculosis kyphosis deformity in active stage by posterior-only column shortening, focal debridement and titanium mesh bone grafting. Statistical analysis was performed by measuring the deformity angel, TK, PI, LL, PT, SVA, VAS score, ODI score, and JOA score etc. before and after operation. Results All cases were followed up for 24-60 months, with an average of 36 months. During the follow-up period, there were no broken nails, infections, complications such as titanium mesh fracture and sedimentation.After the operation, the convex angle, TK, PI and PT were significantly improved compared with those before the operation.At the last follow-up, TK, LL and SVA were not significantly lost. The postoperative VAS score, postoperative ODI score and postoperative JOA score were significantly lower than those before operation, and the difference was statistically significant.Conclusion Treatment of thoracolumbar tuberculosis kyphosis deformity in active stage by posterior-only column shortening, focal debridement and titanium mesh bone grafting technique is a safe and effective method for treating active thoracolumbar tuberculosis with kyphotic deformity.