To observe the surgical efficacy of Chance and flexion separation type thoracolumbar fractures. Methods: There were 11 cases in the group, 7 males and 4 females, aged 31-53 years, average 41 years. The neurological function was Frankel grade A in 2 cases, grade B in 2 cases, grade C in 2 cases, grade D in 4 cases and grade E in 1 case. The majority of the patients had unstable fractures, which were stabilized immediately after surgery, shortening the length of hospitalization and bed rest, and were followed up for 11 to 24 months (mean 16 months). All eight incomplete paraplegics showed improvement of Frankel grade 1 or higher. Conclusion: Treatment of Chance and flexion-detached thoracolumbar fractures with the pedicle internal fixation system restores spinal stability earlier and facilitates neurological recovery. Chance fracture is a rare fracture in the thoracolumbar segment and is a special type of flexion-detached fracture, which has various names, such as seat-belt fracture, horizontal fracture, and flexion-distraction fracture. Treatment methods ranging from conservative treatment, Harrington’s treatment, internal fixation of the pedicle and external fixation of the pedicle have all been reported.