Objective  To explore the clinical effect of posterior palliative decompression and pedicular screws fixation combined with vertebroplasty in treatment of thoracolumbar spinal metastases.Methods  From Aug.2017 to Dec.2019，a total of 21 patients (9 men and 12 women) with thoracolumbar spinal metastases were treated in our department，with an average age of(58.8±7.84)years(range：45~76 years).All patients had nervous system damage and severe thoracolumbar back pain.They were treated with the surger of palliative resection of the debulk tumor，decompression of the spinal cord，insertion of the pedicle screws system to restore the stability and injection of bone cement in the vertebra of tumor.Visual analogue scale(VAS) and Oswestry dysfunction index(ODI) were applied to analyze the improvement of the back pain and life quality 1 day before surgery，1 week postoperatively and at the last follow-up.Results  All the operations were successfully completed.7 patients had bone cement leakage in the procedure of vertebroplasty，and complications due to heat-induced effects and toxicity did not occur.All the 21 patients were followed up and the average follow-up time was (9.0±1.5)months (range：6~12 months).The symptoms of thoracolumbar back pain were instantly relieved after operation.The scores of VAS decreased significantly from (8.40±1.28)points preoperatively to (2.52±0.60 )1 week postoperatively，and (2.86±1.04)points at the last follow-up.There were significant decrease in ODI scores from (69.43±7.45)points preoperatively to (24.16±4.41)points 1 week postoperatively and (26.48±5.22)points at the last follow-up.The difference of the VAS scores and ODI scores in 1 week postoperatively and at the last follow-up were statistically significant comparing with that preoperatively (P＜0.05).There was no loosening，fracture or pull-out of the screw，and no migration of the bone cement.All patients had neurofunction improved at least one Frankel grade after surgery.Four patients had local recurrence，of which 1 patient had a Frankel grade B at the 8 months follow-up after surgery and was not reoperated.The other three patients，who had symptoms of nerve root compression，continued to receive local radiotherapy or chemotherapy.Conclusion  The methods of posterior palliative decompression and pedicular screws fixation combined with vertebroplasty in treatment of thoracolumbar spinal metastases can efficiently reduce the thoracolumbar back pain and improve patients’ life quality with advanced cancer.This method gains satisfactory short-term clinical outcomes.