Fractures of the thoracic and lumbar spine are often treated successfully without surgery. Patients best suited for recumbency are those without deficit and minimal angular deformity and canal compromise. Angulation less than 20 dg, residual spinal canal of 50% or greater, and an anterior body height greater than 50% of the posterior height were additional criteria used in selecting recumbency. Patients were kept at bed rest for 1 to 4 weeks or until their pain resolved. They were then mobilized gradually in molded thoracolumbar orthoses for 3 to 5 months with sequential radiographs.