Abstract: OBJECTIVE To compare the effects of X-ray, multi-slice CT and MRI on diagnosis of thoracolumbar vertebral tuberculosis.METHODS A total of 82 patients with spinal tuberculosis (208 vertebrae) who were treated in the hospital from Dec 2012 to Dec 2016 were recruited as the study objects and received X-ray, multi-slice CT and MRI examinations, and the accuracy and sensitivity were observed and compared among the three examination methods.RESULTS The X-ray showed vertebral destruction, paraspinal abscess, intervertebral space stenosis or destruction. The CT mainly showed paravertebral abscess, destruction of vertebral body and accessories bone and sequestrum. The MRI mainly showed change of intervertebral disc signal, destruction of vertebral and accessories bone, paraspinal abscess, spinal cord involvement and ligament spread. The positive rates of detection of vertebral body destruction, spinal canal involvement, paraspinal abscess and intervertebral disc involvement were higher by the multi-slice CT and MRI than by the X-ray (P<0.05). The positive rate of detection of sequestration and average score were higher by the multi-slice CT than by the X-ray and MRI (P<0.05). The positive rates of detection of intervertebral disc involvement, spinal canal involvement, vertebral body destruction and paraspinal abscess and average score were higher by the MRI than by the multi-slice CT (P<0.05). The time of detection of foci was shorter by the multi-slice CT and MRI than by the X-ray, while the examination time was longer by the multi-slice CT and MRI than by the X-ray (P<0.05); the examination time was longer by the MRI than by the CT (P<0.05).CONCLUSION Multi-slice CT combined with MRI, as is used for early diagnosis of spinal tuberculosis, may raise the rate of early diagnosis and have great significance in clinical treatment of the spinal tuberculosis.