A fracture of the thoracolumbar spine due to a trauma can be a devastating event. 5 – 15 % of the fractures are accompanied by spinal cord injury (8,9,10). The worst case scenario is a complete spinal cord lesion. This includes loss of all sensory and motor function caudal to the injury site. According to guidelines, any patient with a suspected spinal cord injury should receive a regimen of IV methylprednisolone (5). An unstable spinal fracture is defined by its ability to cause further spinal cord damage (8). To avoid this, these fractures are usually managed surgically. At Ullevål University Hospital (UUS) such fractures are stabilized using an internal fixation system called Universal Spine System (USS). In the period between October 1999 and May 2003, 56 patients received treatment for unstable thoracolumbar spinal fractures at UUS. We wanted to examine who got such fractures, what kind of treatment they received, and what happened to them after they were discharged. Mean age of the patients was 36.8 years, and 71% of them were male. All patients received internal USS-fixation, and most of them (82 %) had a laminectomy conducted. 43% had a bone graft transplant. 68% received methylprednisolone according to guidelines. One patient had to be re-operated due to surgical complications. 18% had the implant removed after some time. 23% had follow-up examinations at UUS.We also studied literature regarding spinal fractures in general, the use of methylprednisolone in the treatment of spinal injuries, and the use of trauma scoring systems.