Purpose Aged patients represent a high risk group for acquir-ing spinal tuberculosis,and it still remains a leading cause of kyphosis and paraplegia in developing nations.Aged patients often combined with cardiovascular and respiratory disease and single lung ventilation via anterior approach surgery could result in more post-operative complications.We aimed to ana-lyze the efficacy and feasibility of surgical management of aged patients with lumbo-sacral spine tuberculosis using one-stage posterior focus debridement,interbody graft using titanium mesh cages,posterior instrumentation,and fusion.Methods From March 2009 and July 2012,17 aged patients with lumbo-sacral spinal tuberculosis were treated with one-stage posterior focus debridement,interbody graft using tita-nium mesh cages,posterior instrumentation,and fusion.There were eight male and nine female with a mean age of 63.3 years (range: 60-71 years).The mean follow-up was 46.5 months (range 38-70 months).Patients were evaluated before and after surgery in terms of ESR,neurological status,visual ana-log scale (VAS),and lumbosacral angle.Results Spinal tuberculosis was completely cured and the grafted bones were fused in all 17 patients.There were no recurrent tuberculous infections.ESR became normal within three months in all patients.The ASIA neurological classification and VAS scores improved in all cases.The average preopera-tive lumbosacral angle was 20.6° (range 18.1°-22.5°) and became 29.4° (range 27.1°-32.5°) at final follow-up.Conclusions Our results showed that one-stage posterior fo-cus debridement,interbody graft using titanium mesh cages,posterior instrumentation,and fusion was an effective treat-ment for aged patients with lumbo-sacral spinal tuberculosis.It is characterized with minimum surgical trauma,good pain relief,good neurological recovery,and good reconstruction of the spinal stability.