Abstract: Objective To analyze the clinical feasibility of posterior approach focus clearance, mixed granula-impacted bone graft in combination with intervertebral screw fixation in treating patients with lumbosacral vertebral tuberculosis. Methods A total of 35 patients who were treated by posterior approach focus clearance, mixed granula-impacted bone graft in combination with intervertebral screw fixation in the Department of Orthopedics, Tuberculosis Hospital in Jilin Province were retrospectively analyzed. Among them, 30 patients completed a follow-up period of 18 months, including 17 males and 13 females, with an average age of (49.33 ± 10.98) years (ranged 29 to 68 years). The clinical outcome was evaluated by surgical treatment, postoperative fusion time of bone graft, spinal cord injury according to Frankel Grading System, pain visual analogue scale (VAS), and improvement in lumbosacral angle. Results There were no complications such as vascular injuries, incision infection and urinary incontinence occurred among the 30 patients. Three cases developed unilateral lower limb radiation pain, and the pain was relieved after 2 months, was conducted after surgery. Anteroposterior and lateral plain film X-rays were obtained to follow-up. The bone grafts were fused within 6 months in 23 patients, within 9 months in 2 patients, within 12 months in 2 patients, and within 18 months in 3 patients. Preoperative spinal cord injuries were classified as grade E in 15 cases, grade D in 13 cases, and grade C in 2 cases. The injury was improved 12 months after surgery (grade E in 27 cases and grade D in 3 cases). The VAS score and lumbosacral angle were (0.83±0.59) and (27.10±3.16)° 18 months after surgery, (2.23±0.63) and (29.20±3.48)° 1 week after surgery, and (5.03±1.99) and (22.49±3.85)° before surgery; the difference was statically significant (F=111.14, P<0.001; F=142.79, P<0.001). The lumbosacral angle was notably increased 1 week after surgery compared with before surgery; the difference was statically significant (t=－7.09, P<0.001). Eighteen months after surgery, the increase in lumbosacral angle was eliminated a little; however the increase was still significant when compared with the baseline before surgery (t=－5.08, P<0.001). Conclusion Posterior approach focus clearance, mixed granula-impacted bone graft in combination with intervertebral screw fixation achieved good therapeutic efficacy for lumbosacral vertebral tuberculosis, and thus could be used as a promising operative method in clinical practice.