Purpose Various surgical methods have been described for the management of lumbar tuberculous spondylitis in the literature.However,there were few reports on the two-stage surgical treatment of lumbar tuberculosis in children of elementary school age.We present a retrospective clinical study of 14 patients with lumbar and lumbosacral tuberculous spondylitis treated by two-stage surgery (first stage: posterior instrumentation;second stage: anterior debridement and allografting).The purpose is to determine the clinical efficacy of such surgical treatment for lumbar tuberculosis in children.Method Our series was comprised 9 males and 5 females with an average age of 7.5 years treated with the above-mentioned surgical procedure.All patients had lumbar and lumbosacral involvement with one patient having spondy-litis at L2-3,three at L3-4,seven at L4-5,and three at L5-S1.All patients had single motion segment involve-ment.The Frankel scoring system was used to assess the neurological deficits.Frankels grade B in two patients,grade C in four and grade D in eight.The following data were followed-up for an average period of 50.1 months (42-64 months) in these patients: healing of disease,deformity correction and its maintenance,neurologic function,and spinal bony fusion.Results The average preoperative local deformity angle was-13.8°,correcting to 3.4° postoperatively and 1.5° at the final follow-up.With the exception of one patient who received a D at the final follow-up,all cases obtained complete neurological recovery.No breakage and loose-ness of internal fixation was found.Bony fusion was achieved in all cases within 6 months postoperatively.There was no recurrent tuberculous infection.Conclusion Two-stage (posterior and anterior) surgery is a safe and effective procedure for the patient of elementary school age suffering from lumbar and lumbosacral tuber-culous spondylitis,especially for the patients in poor general condition.The procedure has the advantage of minor surgical invasion,effective kyphosis correction and less complications.