Objective To explore the risk factors for retreatment of spinal tuberculosis and to provide a theoretical basis for the formulation of clinical prevention and treatment measures. Methods the clinical data of 114 patients who received spinal tuberculosis operation from January 2011 to June 2014 were retrospectively analyzed. Among them, 13 cases were divided into group A after operation, and 101 cases without recurrence after operation were divided into B group. The clinical data of the two groups were compared and the multiple factor Logistic regression was used to analyze the risk factors for retreatment of spinal tuberculosis. Results In group A, preoperative albumin level, after standard anti-tuberculosis treatment, the proportion of complete removal of the lesion was significantly lower than that in group B, and tuberculosis in other parts of the proportion, the emergence of resistant strains, proportion of adverse conditions were significantly higher than those in group B (P＜0. 05). Multivariate Logistic regression analysis showed that preoperative albumin < 35g/L, without fusion, patients who did not receive regular anti-tuberculosis treatment, debridement is not complete, with other parts of tuberculosis, drug resistant strain and adverse conditions were risk factors of postoperative spinal tuberculosis retreatment (P＜0. 05). Conclusion Many factors can affect the incidence of relapse after spinal tuberculosis surgery, and clinical intervention should be carried out to reduce the risk of relapse after spinal tuberculosis operation.