Osteomylitis of the spine is an inflammatory destruction of at least one spinal unit, initially caused by bacteria settling in capillaries of the vertebral end plate. In patients with major bone destruction, neurological impairment, antibiotic resistant sepsis, or recurrence of infection and pain, an operation with anterior debridment and fusion by using autografts is an accepted way of treatment with favorable results. However, rehabilitation after anterior debridment and fusion is prolonged because of minor primary instability making necessary post-operative bed rest, casting and orthotic devices. To shorten and simplify post-operative period, several authors reported addition of anterior or dorsal instrumentation, the last means anterior-posterior exposures. In our opinion, single posterior circumspinal exposure can be used to debride, and reconstruct the spine and at the same time posterior fixation can be added through it. Fifteenpatients of infections of the thoracic and lumbar spine were treated surgically at Sohag University Hospital, Egypt. The patients were 9males and 6females with a mean age of 46years. Levels affected were in the thoracic spine in8patients and 7were in the lumbosacral spine. All patients were operated under general anaesthesia in the prone position through a single posterior exposure. Posterior stabilization by trans-pedicular screw fixation was performed for one level above and one level below the affected vertebra in all but 2 patients. Laminectomy or at least one -sided hemilaminectomy followed by lateral dissection is carried out. In the thoracic spine, about 5 cms from one or two ribs are excised to give access to the verteberal body. Blount anterior dissection using the finger and gauze was carried out. Spatuals-originally developed for posterior total en blocspondylectomy operation by Tomita - were inserted anterior to the vertebral body or bodies. The abscess was evacuated and the lesion was curetted, and biopsed. In all cases, anterior spinal fusion was performed. The anterior defect was reconstructed by limited spinal shortening in 5 patients and by anterior bone grafting in 7 patients. Then, posterior fusion is performed. Post-operatively, a brace was used during walking or sitting for 3 months. Fusion was followed by monthly radiographs. Causative organisms were TB in 8 patients and bacteriologic testing of intraoperative samples did not find germs in 4. Mean follow up was 12.2months (range; 2-32months). No active infection occurred tell the end of follow up. Pre-operative kyphosis angle ranged between + 40° to - 35° and (mean 12.8°). Post-operative kyphosis angle ranged between + 20° and - 40° (mean 0.4°). At the end of follow up, the kyphosis angle ranged between + 23° to - 42° with a mean kyphosis angle 1.3°. No metal failure was encountered tell the end of follow up. In our opinion and based in our experience in management of our patients, the circumspinal exposure of the spine used as a sole approach has a lot of advantages over the anterior or double anterior-posterior exposure in treatment of infections of the thoracic and lumbar vertebrae. It carries less morbidity, spine surgeons are more familial with the posterior exposure than the anterior one, it gives access to both the vertebral body and neural arch and for multiple levels, it gives access to all levels from Th 1 to S1 and complications are less serious. Another main advantage of posterior spinal exposure is that the spinal cord is always under surgeon’s vision during debridment and reconstruction. This is contrary to the situation in case of anterior spinal debridment because the vertebral body lies between the surgeon and the spinal cord that might injure the spinal cord. If dural tear to complicate anterior debridment, dural reconstruction through the anterior exposure is extremely difficult. In conclusion, in cases of thoracic and lumbar spinal infections, single posterior exposure is sufficient to debride the infected material, decompress the neural elements, and reconstruct the spine both anteriorly and posteriorly.