In recent years, with the increase in the incidence of traffic accidents, the occurrence of vertebral fractures has become more and more common. Injuries are often serious and complex, with multiple and compound injuries, many complications, and poor prognosis when combined with spinal cord injury, which can even cause lifelong disability or endanger life. The thoracolumbar spine is the most mobile, and fractures with spinal cord injury are the most common. The fracture of the vertebra is often due to displacement of the vertebral body, fragmented bone, intervertebral discs and other tissues directly compressing the spinal cord, resulting in hemorrhage, edema, ischemia and even fracture and complete contusion of the spinal cord. The weakening and loss of body sensation, motor dysfunction, and sphincter dysfunction caused by the injury often cause great pain and even life-threatening to the patient. Clinically, the diagnosis of thoracolumbar vertebral fracture with spinal cord injury is not difficult. Patients often have a history of severe trauma, such as fall from height, heavy object striking the low back, landslide accident, traffic accident, etc. The injured person feels severe pain in the low back and cannot turn over and stand up. Localized fracture can be found in the limited posterior protrusion deformity. In particular, after spinal cord injury, the pain, touch, temperature sensation of the skin below the plane of the injured vertebrae is reduced or disappeared, and the motor function of the lower limbs is impaired, and serious loss of control of urination and defecation may occur, such as urinary retention, incontinence, diarrhea and constipation, etc. X-ray, CT, MRI examination can clarify the segment and severity of spinal cord injury in vertebral fractures. These patients have serious injuries, and if the diagnosis and treatment is not favorable, paralysis may occur, followed by decubitus ulcers, respiratory system infection, urinary system infection, plant nervous system dysfunction and many other serious complications. First aid and transport are important in the management and treatment of these patients. When a spinal fracture is suspected, the patient’s spine should be kept straight and the spine should not be over-extended or over-flexed to avoid aggravating the injury. The correct method is to lift the patient with three hands at the same time and put him on a wooden board, or use the rolling method when there are few people. Simple thoracolumbar spinal fracture, if mild vertebral compression, fracture stability is good without spinal cord injury, the patient can lie flat on a hard bed, lumbar padding, so that the compressed vertebral body reset itself, restore the original state. After a few days, the lumbar back muscle exercise can be performed. 3 to 4 weeks later, the patient can get out of bed under the protection of a lumbar back brace. Thoracolumbar spine fracture degree of compression of more than one-third can be closed manipulation reset, reset after the plaster undershirt fixation, fixation time for 3 months. For unstable spinal fractures of the thoracolumbar segment, open internal fixation may be considered for vertebral compression of more than 1/3, deformity angle greater than 20 degrees, or with dislocation. The functional recovery of patients with combined spinal cord injury depends mainly on the degree of injury, but early release of spinal cord compression is a prerequisite for spinal cord function recovery. Surgery is an important part of the comprehensive rehabilitation of patients with spinal cord injury. The goal of surgery is to restore the normal axis of the spine, restore the internal diameter of the spinal canal, directly or indirectly release the compression of the spinal cord from fracture masses or dislocations, and stabilize the spine. The surgical approach is no more than an anterior or posterior approach. For thoracolumbar burst or comminuted fractures, anterior decompression, bone graft fusion, and plate and screw internal fixation are most often performed clinically. The posterior approach includes laminectomy decompression, internal fixation with a steel rod system of pedicle screws and, if necessary, bone graft fusion. Postoperative treatment of the patient includes hemostasis, dehydration, nerve nutrition, and hormone therapy, especially the use of high doses of hormones is important to alleviate the traumatic response of the spinal cord. In addition, caloric, nutritional and vitamin supplements should be effectively enhanced. At present, the thoracolumbar vertebral fracture with spinal cord injury can be effectively treated and managed clinically, and the results are obvious.