Objective. To investigate the unique characteristics and treatment of thoracic spine fractures. Methods. Seventy seven patients with thoracic spine fractures were retrospectively reviewed. Of these

there were 37 compression fractures

34 fracture dislocations

3 burst fractures and 3 burst dislocations. Twenty six patients had a complete lesion of the spinal cord

14 sustained a neurologically incomplete injury

and 37 were neurologically intact. Fifty three patients were treated nonoperatively and 24 treated operatively. Results. All patients were followed up for 2～15 years. None of the 26 patients with a complete lesion recovered any significant function. Of 37 neurologically intact patients

13 had local pain although all of them remained normal function. Two of 14 patients with incomplete paraplegia returned to normal

7 recovered some function and 5 did not recovered. Conclusions. Because of the unique anatomy and biomechanics of the thoracic spine

the classification commonly applied to thoracolumbar fractures is not suitable for thoracic fractures. Fusion and instrumentation are indicated when the fractures are unstable

while patients with incomplete lesion of the spinal cord may be the candidates for supplemented decompression.