Introduction\nThe most frequent traumatic fractures of the spine are in the thoracic and lumbar (thoracolumbar) regions. The transition from the less mobile thoracic spine with ribs and sternum to the dynamic \nspine turns this area into a high stress zone; since most of these injuries are the consequence of high-energy trauma, mainly due to traffic accidents.1,2\n\nObjective: To describe and evaluate the clinical, radiological and postsurgical evolution obtained with different surgical treatment modalities, these modalities are: spondylectomy and posterior expander placement, double approach and posterior fusion with or without decompression in \ntraumatic thoracolumbar fractures.\n\nMethod: A longitudinal retrospective descriptive study was carried out; where patients belonging to the \"Hospital Regional de Alta Especialidad del Bajío\" were included, who presented traumatic \nthoracolumbar fractures and are treated surgically during a period from January 2017 to January 2020. For the diagnosis we use X-ray of the dorsal-lumbar spine, as well as computed tomography \nand magnetic resonance imaging of the dorsal-lumbar spine. We also consider age, body mass index, work and comorbidities.\n\nResults: 39 patients were analyzed, with fractures at various sites; the most frequent fracture was: in L1 and L2, Ao spine type A4 and B2, with the most common mechanism of accidental falls. For the McCormack classification, 20 patients were grouped into (less than <7 points) and (greater than or equal to ≥ 7 points, 19 patients). Three surgical treatment techniques were evaluated: A posterior spondilectomy; B Double approach and C Posterior fusion with or without decompression. In the clinical evaluation by ENA all cases showed improvement, while ASIA there was improvement in most cases; except for one case with deterioration for group C) which represented 2.5%. Subsidence \noccurred in 23.07% (N 13) belonging to two patients with technique A) and one patient with technique B). Fusion was present in 71% (N 28), regarding angulation in all techniques there was no significant difference; however, the comparison of techniques per McCormack group equal to or greater than ≥7, a significant difference p = 0.021 was found between technique A) and technique C).\n\nConclusions. For decision making, our results suggested that fractures classified with AO Spine, \nMcCormack and ASIA, are determined for surgical treatment, for McCormack equal to or greater than ≥7 points posterior spondylectomy or double approach with long instrumentation if ASIA C, D \nand E and for the ASIA A and B long constructs only with a posterior approach, always considering the characteristics of the patient, age, body mass index, work and comorbidities.