The classification and treatment of thoracolumbar injuries remain controversial. The Spine Trauma Study Group (STSG) has developed a classification system that has prognostic significance and helps guide treatment decisions. It is based on three aspects: morphology of the injury, integrity of the posterior ligamentous complex, and neurological status of the patient. A severity score is used in conjunction with the classification system to help guide treatment decisions. This classification system has been shown to have good inter- and intra-observer reliability.