Intervertebral disc degeneration (IDD) and osteoarthritis (OA) are common clinical degenerative diseases of the spine, which seriously affect people's quality of life, and there is currently no effective cure. Crosstalk between exosomes of different origins and autophagy can delay the progression of IDD and OA, and its mechanism of action involves inhibition of related apoptosis and protection of extracellular matrix. By summarizing the relevant literature in recent years, this article reviews the application status of crosstalk between exosomes and autophagy in the diagnosis and treatment of spinal joint degenerative diseases, and finds that autophagy is an emerging target for the treatment of spinal joint degenerative diseases, and exosomes contain a variety of bioactive substances required for bone reconstruction, and the crosstalk between the two can further improve the efficacy of IDD and OA, in order to provide reference for future research in this field.