METHODS A study on computed tomography (CT)-based finite element (FE) method that predicts vertebral strength and fracture site using human cadaveric specimens. OBJECTIVE To evaluate the accuracy of the nonlinear FE method by comparing the predicted data with those of mechanical testing. BACKGROUND FE methods may predict vertebral strength and fracture site but the prediction has been difficult because of a complex geometry, elastoplasticity, and thin cortical shell of the vertebra. METHODS FE models of the 12 thoracolumbar vertebral specimens were constructed. Nonlinear FE analyses were performed, and the yield load, the fracture load, the sites where elements failed, and the distribution of minimum principal strain were evaluated. A quasi-static uniaxial compression test for the same specimens was conducted to verify these analyses. RESULTS The yield loads, fracture loads, minimum principal strains, and fracture sites of the FE prediction significantly correlated with those measured. CONCLUSIONS Nonlinear FE model predicted vertebral strength and fracture site accurately.