Objective: To investigate the feasibility and the clinical efficacy of treatment for upper thoracic spinal tuberculosis by one-stage posterior debridement, interbody fusion, and instrumentation. Methods: From July 2011 to July 2015, a total of 20 patiens suffering from upper thoracic spinal tuberculosis were collected. There were 13 males and 7 females, with age ranging from 24 to 72 (51.7±14.0) years old. The kyphotic Cobb angle of segmental spinal lesions pre-operation were 31°–53° (46.7°±8.4°). The neurological examination according to American Spinal Injury Association (ASIA) showed grade B in 2 cases, grade C in 9 cases, grade D in 8 cases, and grade E in 1 case. All the patients were treated with one-stage posterior debridement, interbody fusion, and instrumentation. Results: All patients were followed for 36–60 (46.7±8.4) months post-operation. No severe complications occurred. The kyphotic Cobb angle were 15°–25° (20.4°±3.0°) after the surgery, and at final follow-up were 16°–26° (21.3°±3.0°), which both was significantly decreased form the pre-operation (P<0.05). At the last follow-up visit, neurological status of the patients with preoperative neurological deficit according to ASIA: 2 cases in grade B recovered to grade D, 4 cases in grade C recovered to grade D, 5 cases in grade C recovered to grade E, 8 cases in grade D recovered to grade E. Visual Analogue Scale (VAS) pain score were significantly improved at the end of follow-up (P<0.05). Bone fusion occurred in all patients at 9–15 (11.7±1.9) months after the surgery. No fixation loose or breakage, and no pseudo articulation formation. Conclusion: One-stage posterior debridement, interbody fusion, and instrumentation can be an effective and feasible treatment option for upper thoracic spinal tuberculosis offering less trauma, and complications, the clinical effect was satisfied.