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After a 2-year follow-up, the patient was pain free and the CT scan revealed bone fusion. The vascular structures involved in severe thoracolumbar fractures present a dangerous situation that should be considered in the choice of the surgical approach. The posterior approach alone may be a good option in the absence of vascular damage. However, due to risk of vessel rupture during the fracture reduction, vascular surgeons must take part in the surgery. 5. The article provides help for surgeons who have to treat severe fractures in t