Objective: To investigate the short-term and medium-term efficacy of one-stage posterior debridement, intertransverse process bone grafting and screw-rod system fixation in the treatment of Brucella spondylitis of the lumbar spine. Method: 156 cases of Brucella spondylitis of lumbar spine were selected and divided into experimental group (n = 80) and combined group (n = 76) according to different surgical methods. The experimental group was treated with one-stage posterior debridement, intertransverse process bone grafting and screw-rod system fixation. The combined group was treated with one-stage anterior debridement and intertransverse process bone grafting combined with posterior intal fixation. The operative indexes and clinical effects were compared between the two groups. Result: The operation time, intraoperative bleeding volume and time of landing after operation in the experimental group were less than those in the combined group, with statistical significance (P<0.05). VAS score, ODI index, Cobb angle and Frankel grade of nervous function in the two groups were significantly improved after 3 months and 36 months of treatment (P<0.05), but there was no significant difference between the two groups at the same time (P>0.05). There was no significant difference in the excellent and good rate between the two groups after 3 and 36 months of treatment (P>0.05). There was no recurrence of the lesion in both groups. The intertransverse process bone graft healed and the screw-rod system was well fixed. Conclusion: One-stage posterior debridement, intertransverse process bone grafting and screw-rod system fixation for treatment of Brucella spondylitis of lumbar spine are effective, with short operation time and less trauma, which are worthy of clinical promotion.