A total 37 cases of tuberculous spondylitis of thoraco-lumbar junction had been treated by anterior decompression and interbody fusion. According to the level and vertebrae invoived, all the cases were classified into four groups, for it was mandatory to have some modification in the details of surgical technique in each group. This variation in the operative technique was also arranged into several types. The postoperative course was uneventful and complications were minimal in most of them: Paraplegia recovered completely in three out of four,the kyphotic angle in 22 cases with follow-up of more than three years showed that most of them remained almost unchanged, while in two it had progressive worsening, and in three it showed progressive improvement. The clinical experience gained in this study leads us to conclude that the retropleural-retroperitoneal approach for tuberculous spondylitis of the thoraco-lumbar junction is the method of choice and so recommended especially in poor risk patients.