Thoracolumbar spine fractures generally occur due to high energy traumas. Therefore, first of all, airway, breathing, and circulation must be checked. Haemothorax, pneumothorax, urogenital injuries, and solid abdominal organ injuries may accompany the spine fractures frequently. Neurologic evaluation is very important after systemic examinations. Sensation, motor movements, and reflexes should be checked. ASIA scoring and Frankel grading systems may be used for neurologic evaluation and registration. Bulbocavernous reflex negativity in the patients with total neurologic loss in early post-traumatic period may indicate the spinal shock. The prognosis is very poor in total paraplegics but some neurologic impairment may be seen in the patients with incomplete neurologic deficit.