The authors report an unusual case of spinal tuberculosis involving the posterior arch of T12 without disk lesion in a 20-year-old woman presenting with posterior compression of the spinal cord. The diagnosis was suggested at CT and MR imaging and confirmed by histological study after surgical resection. CT provides good evaluation of the bony lesion and may suggest intraspinal extension. MRI is superior for evaluation of cord compression. The patient improved after surgical and medical treatment. The imaging features of this entity are reviewed.