Gold standard treatment choice for thoracolumbar fractures is still unclear. The purpose of this paper is to review the results of conservative treatment options for thoracolumbar vertebra fractures. A comprehensive search of the English literature over the past 26 years was conducted using PubMed (MEDLINE). Comprehensive and up to date studies including these 26 years have been reviewed. The inclusion criteria consisted of burst fractures resulting from a traumatic mechanism, and fractures of the thoracic or lumbar spine. The exclusion criteria consisted of osteoporotic burst fractures, pathological burst fractures, and fractures located in the cervical spine. We have examined 2 Level I, 7 Level II, total 49 studies. This is one of the largest studies examining burst fracture patients, adjusting for both clinical and radiologic confounders and reporting patient outcomes with early and late follow up. The conservative management of thoracolumbar spine fractures is based on the patient`s clinical condition, expectations, the experience of the physician, and treatment options. There is still no consensus on gold standard treatment for stable spinal fractures. In most of the publications, patients with neurological deficit were excluded from the study and no correlation was found between the functional recovery and radiological improvements in the remaining patients. No differences were found in outcomes between patients treated either surgically or nonsurgically.