Traumatic injuries of the thoracolumbar spine are often complex and affect the bony structures and disco-ligamentous structures of the spine. In addition to adequate primary therapy, the appropriate choice of diagnostic procedures and treatment methods, which take the particular biomechanical characteristics of the individual fracture type into consideration, is essential for successful outcome and thereby the restoration of patient quality of life. In the case of a surgical indication, the procedure can be performed either in one or two sessions and can include dorsal, ventral or combined dorso-ventral spondylodesis. With minimally invasive and computer-assisted techniques becoming routine procedures, safe and sparing treatment of these fractures is possible.