This paper made a paleopathological analysis and diagnosis of two cases of rare vertebras pathological lesions from the Jiayi Cemetery, a Bronze-Iron Age cemetery from Xinjiang, China. We speculated on the most likely type of disease, and at the same time, combined with the living environment of these two individuals, we explored the external factors that caused the patients to become ill. After identification, M172 is a minor of 10-12 years old, and M167 is a female about 35 years old. Two cases showed serious osteolytic lesions in the vertebras: endplate damage, internal cancellus dissolution and absorption. Before the paleopathological diagnosis of bones, we first observed the local bone damage through a super-depth three-dimensional digital microscopic analysis system. We found that there were traces of healing in the bones in the damaged area, thus ruling out the possibility of bone damage caused by buried factors, All skeletal injuries are caused by diseases that the individual suffered from during his or her lifetime. The cavitation of the middle vertebral body had formed hollow phenomenon. In M172, focal lytic lesions were found in hand phalanges, vertebra, pubis and scapulae, ribs and tibia showed significant local new bone formation; the third and fourth lumbar vertebrae of individual M167 showed vertebral collapse due to severe dissolution. Through CT and X-ray imaging analysis of bone injury morphology, bone damage area characteristics, combined with clinical medical data for differential diagnosis, the results suggest that Degenerative arthritis, compression fractures, and Scheuermann disease were excluded because they do not cause osteolytic changes, and two individuals might suffer from spinal tuberculosis, rather than purulent osteomyelitis, brucellosis, actinomycosis, bone cancer metastasis and some other fungal infection. Archaeological excavations of the site show that from the 8th century BC to the 5th century BC, people living in the Turpan area lived a life based on animal husbandry, mainly raising cattle, sheep and horses, which led to their frequent contact with livestock. Cattle are considered to be among the most infectious livestock to humans, including the consumption of meat and dairy products and even the reuse of feces and urine. In addition, backward medical and health factors increase the probability of zoonosis and meet the conditions for the spread of tuberculosis. The Turpan Basin is located in the middle of the Eurasian steppe and was an important location on the ancient Silk Road in China. There were close exchanges between different groups of people. This study is of great significance to the health assessment of the population in the region.