Objectives: To review the clinical effect of anterior approach treatment for lower thoracolumbar vertebral fractures under Video-assisted Thoracoscopic.Method: 9 patients who underwent thoracoscopic decompression and reconstruction of the spine from December 2005 to March 2007 have been reviewed retrospectively.Among them, 8 patients were male, 1 was female.The patients range from 17 to 56years old; 34 is the average.There were 5 cases ofT12, 2 cases of T11, 1 cases ofT10, 1 cases ofT8 vertebrae body fracture in all the data.All the patients performed the fracture vertebrae body resection, fusion with iliac crest, internal fixation with MACS-TL system.Results: All the patients operations were successfully performed.The operation duration was from 3.5~8 hours; 5.2 hours is in the average.The blood loss is 600~3800 rnl, 1200 ml in the average.All the patients were followed up in 3months, 6 months, and 12 months after the operation.All the patients got bony fusion.There is no neurological function deterioration or other complications.Conclusion: Thoracoscopic decompression, fusion and internal fixation of the thoracical spine in the effective method to treat the lower thoracicalr vertebral fractures