Between January 1983 and December 1997, 29 patients with either a fracture (11 patients) or a fracture-dislocation (18 patients) of the thoracic spine were treated operatively. All patients underwent posterior decompression and stabilization within a mean time of 4 days after injury (range, 0-45 days). Patients with complete paraplegia had no postoperative improvement in neurologic status, whereas all patients with incomplete spinal cord lesions improved in neurologic status after surgery. There was no significant association between time from injury to operation and final neurologic outcome. For thoracic fractures, the procedure of surgical decompression and stabilization is safe, and neurologic recovery may be anticipated in patients with incomplete spinal cord lesions.