Abstract： Objective To investigate the effect of hyperbaric oxygen treatment and posterior atlas internal fixation on patients with thoracolumbar spine fracture coupled with spinal cord injury. Methods Ninety -six cases of thoracolumbar spine fracture coupled with spinal cord injury admitted into the hospital from December 2000 to September 2009 were divided into 3 groups: the combined therapeutic group ( the HBO + AF group ), the posterior atlas fixation group (the AF group) and the HBO treatment group (the HBO group). The HBO group was treated purely with 3 sessions of HBO therapy for 30 days with an average of 4.5 days after injury or operation. The AF group was treated simply with posterior atlas internal fixation with an average of 4.3 days after injury. The treatment effects of the three groups were studied respectively after therapy. Close observations were made on the effects of both HBO treatment and posterior atlas internal fixation and also prognosis of each group. Results The effective rate of the combined therapeutic group was 92.8 %, while those of the AF group and the pure HBO group were 71.4 % and 52.6 % respectively. The combined therapeutic group showed better treatment effects than the AF group ( P ＜ 0.05 ) and the HBO group ( P ＜0. 01 ). Conclusions Posterior atlas internal fixation combined with HBO treatment produced obviously better effects than simple posterior atlas internal fixation or pure HBO treatment.