Anterior spinal decompression and fusion was used as the primary treatment for thoracolumbar fractures in eleven patients with neurological deficits. Each patient achieved stability by interbody fusion. Significant progressive kyphosis did not occur. No patients with a complete neurological deficit was improved by operation, but all eight patients with partial neurological deficits showed improved lower extremity motor function postoperatively. Bladder function improved in five of the eight patients with incomplete lesions. The authors recommend this operative approach for spinal stabilization and removal of anteriorly located bone or disc fragments causing progressing and stable partial neurological deficits, and find second-stage posterior fixation with Harrington rods unnecessary in the great majority of cases.