Abstract: [Objective] : To investigate the surgical efficacy and influential factors of paralysis recovery in patients with thoracic tuberculosis and paraplegia, so as to provide guidance for the evaluation of prognosis.[Methods] : The clinical data of 48 patients with thoracic tuberculosis and paraplegia admitted to our center from April 2014 to April 2019 were retrospectively analyzed. A total of 45 patients were included in the study.Among them, there were 23 males and 22 females, aged 17 ~ 80 years old, with an average age of (57.33±15.12) years old.Preoperative spinal cord injury had grade A in 1 case, Grade B in 30 cases, Grade C in 4 cases and Grade D in 10 cases.All patients underwent posterior thoracic surgery, including 1 patient who underwent laminectomy only, and 2 patients who underwent retreatment underwent revision internal fixation.Is fully recovered and did not fully recover two groups of patients with paraplegia before paralysis between sex, age, course of paralysis (local symptom duration), preoperative time, preoperative ASIA classification and degree of spinal cord compression, lesion location, number of involvement of vertebral body, preoperative after segmental convex Angle, the average operation time, bleeding amount of average rate of the protruding after correction, whether drug-resistant TB and other indicators, to study the influencing factors of postoperative paraplegia recovery.[Results] : The operative time of 45 patients ranged from 150min to 470min, with an average of (274.22±67.20) min; the intraoperative blood loss ranged from 200ml to 2000ml, with an average of (877.78±393.06) ml; the preoperative VAS score was an average of (6.02±2.03) points; the last follow-up was an average of (2.44±1.10) points, and the differences were statistically significant.Preoperative kyphosis Angle was 2.6° ~ 30.2°, with an average of (12.21°±6.37°); postoperative kyphosis Angle was 1.6° ~ 25.0°, with an average of (6.97°±4.17°); the average correction rate of kyphosis was 8.4% ~ 71.2%, with an average of (38.94% ± 19.41%).Tuberculosis culture and drug sensitivity test indicated 6 cases of drug resistance.Incision delayed healing in 2 cases, sinus tract formation in 1 case, healing after dressing change, no patient underwent surgery again.At the last follow-up, 23 patients recovered to ASIA E and 22 did not (16 patients with ASIA D, 5 with ASIA C and 1 with ASIA B). [Conclusion] : the influence of thoracic spinal tuberculosis with paraplegia patients postoperative paraplegia recovery risk factors including preoperative paralysis time is long, low preoperative ASIA, classification and degree of radiographic spinal cord compression, drug-resistant TB and so on, as soon as possible after surgery, sufficient decompression, correct protrusion deformity, based on the drug sensitive test of individualized chemotherapy of paraplegia recovery is of great significance.