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Study design: A retrospective review with clinical and radiologic assessment was conducted.Objective: The purpose of this article was to demonstrate the feasibility of posterior short segment augmentation with iliac screws and posterior lateral fusion and anterior debridement and drainage in sacrum tuberculosis (TB) by evaluating clinical results, fusion status, and sagittal angle.Methods: Sixteen patients with sacrum TB underwent posterior instrumentation with upper level pedicel screws and double iliac screws on each side of iliac ala followed by anterior Debridement and drainage by a single surgeon.The clinical outcomes were evaluated with preoperative and postoperative questionnaires, and the radiographs were independently analyzed with respect to fusion status and sagittal angle.Conclusion: This technique appears to be effective in stabilizing the spinopelvic region, restoring lordosis, achieving a solid fusion, and improving clinical outcome without sacrificing additional motion segments.