Introduction: Tuberculous spondylitis is the most common form of extrapulmonary tuberculosis. Predominantly, those affected by TBS are from underprivileged socio-economic groups, frequently incapable of affording costly therapies and taking prolonged leaves from work owing to economic hardships. The aim of this research is to assess the functional and radiological outcomes of single-stage transpedicular decompression, debridement, posterior instrumentation, and fusion in managing thoracic tuberculosis. Methods: This investigation is a combined prospective and retrospective clinical study was done with 15 cases at Orthopedics Department at the Kamineni Institute of Medical Sciences, Narketpally, Telangana between October 2017 and September 2019. Results: The study included 15 patients, with an average age of 45.8 years. Six had two vertebrae involved in their condition, seven had three, and two had four. All patients had neurological symptoms before surgery, and after 18 months of anti-tuberculous therapy, patients showed substantial improvements in their neurological grading. The average time patients had neurological symptoms before surgery was 9.7 weeks, and they received anti-tuberculous therapy for an average of 2.1 weeks before surgery. At final follow-up, the majority of patients had either excellent or good functional outcomes. Conclusion: In conclusion, our study shows that spinal instrumentation is safe and crucial for spine stabilization in active tuberculosis cases. Despite its demanding nature, single-stage decompression with fusion and kyphosis correction can prevent neurological complications and expedite healing.