Aim: To invastigate the surgical treatment effect of Lumbar-sacral spinal tuberculosis, and proposed a classification system to guide surgical decision making. Result: We restrospectively reviewed all Lumbar-sacral spinal tuberculosis the cases from january of 2014 to January of 2019. And all the patients were followed. Clinical therapy effect and complicaitons were analysized. And a clinical classfication was proposed. Result: There were 15 patitents, 6 females and 9 males. Patients’age ranged from 25 to 65 years old. Preoperative ODI was 32.5±8.7, and the last follow-up was 6.2±4.6（P<0.05）. Preoperation VAS was 6.2±1.6, AND the last follow-up was1.0±0.5（P<0.05）.There was no mortality case, one case with surgical site infection, which was treated after debridement. There was one case with broken rod, but no clinical syptoms. There were 7 cases presenting as the first sacral bertebral body destruciton, 5 cases presenting as the fifth lumbar bertebral body destruciton, and 3 cases presenting as disc space destruciton. Conclusion: Clinical therapy decision making could be planed according to the proposed classification when treating lumbar-sacral spine tuberculosis. And good treatment effect could be expected.