Objective To analyze the bone metabolism related indexes of spinal tuberculosis, and to compare the value of CT and MRI in the diagnosis of spinal tuberculosis. Methods Forty-seven cases of patients with spinal tuberculosis who were treated in our hospital between January 2014 and January 2016 were enrolled in the observation group. All patients underwent CT and MRI examination. The display rates of CT and MRI in spinal tuberculosis with destroyed vertebral body, disc involvement and spinal canal stenosis were observed and compared. Another 50 cases of normal people who underwent health examination in the same period were selected as control group. Bone gla protein (BGP) and other bone metabolism indexes in the two groups were determined. Results The display rate of CT for spinal cord compression was 12.77% while MRI was 40.43% (P< 0.05). There was no significant difference in displaying spinal stenosis and paravertebral soft tissue abscess between the two methods (P>0.05). The differences in levels of serum alkaline phosphatase (ALP), type I collagen C terminal peptide (CTX-I) levels between the two groups were significant(P<0.05). Conclusion Both of CT and MRI can well display intervertebral disc involvement of spinal tuberculosis, spinal stenosis and other signs. However, the display rate of MRI in spinal cord compression is significantly higher than that of CT. The levels of serum ALP and CTX-I have an auxiliary effect on the diagnosis of spinal tuberculosis.