Objective To investigate the curative values of anterior decompression, internal fixation and fusion in treatment of thoracolumbar fractures. Methods Date of 46 cases with thoracolnmbar fractures treated with anterior decompression, internal fixation and fusion from June 2004 to June 2009 were retrospectively analyzed and compared with the follow up results of all cases to observe spinal stability and nerve functional recovery. Results No aggravation of nerve injury appeared in 46 cases. All cases were followed up for 0.5 ~ 5 years,with an average of 2.2 years. The result that the grafted bone had good fusion in all cases, of which, none was found with broken nails and canes. The height of fracture vertebrae was recovered by 94.5% on average.The cobb's kyphosis angle was recovered from 26°preoperatively to 3° postoperatively. Besides, one grade was improved in 23 cases for ASIA grade scores,2 grades in 9 cases and 3 grades in 2 cases, no improvement in 5 cases(x2=16.327 P<0.01). Conclusion The method of anterior decompression and internal fixation is an effective way for thoracolumbar burst fractures, for it can attain complete decompression,high recovery rate of the nerve function, high fusion rate of the grafted bone at one stage and good spinal stability. Key words: Spinal fractures; Internal fixation; Spinal fusion; Anterior decompression