Objective To explore the surgical treatment strategies and the evaluation of spine reconstruction during the treatment of primary suppurative thoracolumbar infection. Methods Retrospectively analyzed the clinical data of 46 patients who were treated surgically from January 2011 to January 2017 in spinal surgery of army specialty medical center.All patients were treated with bed rest

nutritional support and antibiotics

and the lesions were removed surgically if the effect was not good or the symptoms were aggravated.There were 11 cases of simple intraspinal abscess and 35 cases of vertebral body and intervertebral disc infection.For patients of simple intraspinal abscess

the superior spinous ligament and bilateral facet joints were retained

and the medial vertebral plate and spinous process root were removed by ultrasonic osteotomy during the surgery.After the abscess was removed

spinous process lamina replantation and miniplate fixation were performed.For patients of vertebral body and intervertebral disc infection

thorough focus removal

spinal decompression and pedicle screw fixation were performed. Results The operation time was 105 to 190 minutes

with an average of 155 minutes.The amount of blood loss was 55 to 620 mL

with an average of 280 mL.All of the patients were followed up for 12 to 18 months，during which no loosening of internal fixation

incision infection

iatrogenic spinal cord and nerve root injury

replantation tissue displacement

collapse and secondary spinal canal stenosis were found

except for one case of delayed wound healing and one case of postoperative abscess formation 3 years after surgery.The postoperative Xray showed that the spinal integrity was largely preserved after spinous process lamina replantation

and the spinal stability was stable after pedicle screw fixation.Oswestry disability index score decreased significantly after surgery and the difference was statistically significant compared with that before surgery(P<0.05). Conclusion Timely and effective antibiotic application is the basis for the treatment of suppurative spondylitis.For severe suppurative infections and poor general condition

whether the first stage of internal fixation after the removal of the lesion should be carefully selected

when the spine structure is destroyed

abnormalities

extensive lesions

and neurological dysfunction should be treated aggressively.The internal fixation should consider the location of the suppuration and the stability of the intervertebral joints to preserve their flexibility or to rebuild their stability.