Abstract:[Objective] To introduce the surgical technique and preliminary clinical outcomes of one-stage posterior debridement and instrumented fusion for upper thoracic tuberculosis. [Methods] A total of 8 patients received abovesaid surgical treatment for upper thoracic spinal tuberculosis. A posterior midline incision was made to expose the deep structure extended to costotransverse joint and ribs bilaterally. After the transverse process, ribs, and costotransverse joint on the side with severe vertebral destruction were removed, the affected vertebra was fully exposed and the paravertebral abscess was drained. The pedicle screws and rods were installed, the spinal decompression was fin- ished with correction of the kyphosis, and the intervertebral bone defect was reconstructed by titanium cage with bone autograft harvested from the iliac crest. [Results] All the 8 patients were successfully operated on with the operation time of (262.5±43.3) min, intraoperative blood loss of (625.0±333.8) ml, and postoperative drainage of (285.0±118.1) ml. Compared with those preoperatively, the VAS scores [(4.8± 0.9), (0.6 ±0.7),P＜0.001], ODI score [(43.3±14.7)%, (7.6±5.6)%,P＜0.001], ESR [(39.1±13.5) mm/h, (9.8±5.4) mm/h,P＜0.001], CRP [(25.0±14.3) mg/L, (4.7±2.6) mg/L,P＜0.001] were significantly improved at the latest follow-up. In addition, the patients got significant im- provement in neurological function with kyphotic correction rate of (71.5±7.3) % at the latest follow-up. [Conclusion] The one-stage posteri- or debridement with instrumented fusion is relatively simple, less traumatic and effective technique for treatment of upper thoracic spinal tu- berculosis.