Abstract: Objective To study the curative effect of surgical treatment on drug-resistant thoracolumbar spinal tuberculosis. Methods Clinical data about 32 drug-resistant thoracolumbar spinal tuberculosis patients（21 males and 11 females）at the average age of 45.2 years,admitted to our hospital in March 2005-April 2008,were retrospectively analyzed.The patients were classified into Franke l stages A-E in 1,2,8,16 and 5 cases,respectively.The Cobb’s angle ranged 5°-58° mean 29.2°).According to the severity and location of infection,the patients underwent anterior and posterolateral costotransversectomy or posterior debridement and bony grafting with anterior or posterior fixation,followed by anti-tuberculosis chemotherapy for 18-24 months based on conventional and genotypic drug susceptibility testing.The patients were followed up for 3.4 years（range 1.5-4.6 years）. Results All the patients tolerated the operation.Recurrence was found in 1 case who was cured after second operation.X-ray and CT examination showed that the bone was fused in all patients.The average Cobb’s angle was corrected to 19°.Franke l stages E,D and C were observed in 26,5 and 1 cases,respectively. Conclusion The therapeutic effect of surgical treatment is good on drug-resistant thoracolumbar spinal tuberculosis after rational anti-tuberculosis chemotherapy.