Objective To investigate clinical efficacy of transforaminal approach debridement with fusion, thoracolumbar single segment of Brucella spondylitis pedicle screw fixation (TLIF surgery). Methods We analyzed retrospectively the clinical data of 28 patients with Brucella spondylitis treated in our department between January 2009 and January 2014 with TLIF surgery (Group A) and internal fixation with a simple posterior anterior interbody disease debridement, autogenous bone graft (Group B). The two groups were compared in operation time, blood loss, postoperative ambulation time, hospitalization days, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), American Spinal Injury Association (ASIA) classification, visual analogue scale (VAS), Oswestry Disability Index (ODI), Cobb angle of vertebral bone graft healing, and complications. Results All the patients were followed up for an average of 20.2 months (18 to 27 months). They were all cured. Compared with those in Group B, patients in Group A had shorter operation time (164.60±59.19)min, significantly reduced blood loss (346.00±108.90)mL and complications (1 case); significantly shorter postoperative ambulation time (3.36±1.11 days), hospitalization days (17.36±4.19) days and duration (13.16±3.94) months (P<0.05). The two groups did not significantly differ in VAS scores, ODI, ESR CRP, or Cobb angle (P>0.05). Conclusion On the basis of norms of anti-drug treatment for brucellosis, TLIF surgery on Brucella spondylitis has the advantages including less trauma, shorter operation time, easier operation, less bleeding, earlier postoperative ambulation, and lower complication rate. [ABSTRACT FROM AUTHOR]