Abstract: Objective To investigate the clinical application and efficacy of open posterior vertebroplasty in treatment of thoracolumbar metastatic tumor. Methods From January 2013 to March 2015， forty-five patients with thoracolumbar metastatic tumor were treated by the operation of posterior spinal canal decompression tumor resection within the fixation of a short segment pedicle screw and bone cement vertebral reconstruction under direct vision. The lumbar-back pain （VAS score） and neurological damage （Frankel classification） were assessed and compared before treatment and 1 month after treatment. Results Forty-five patients were safe perioperative period. Thirty-three patients have varying degrees of low back pain disappeared in 11 cases， 22 cases of remission. Twenty-six cases with preoperative neurological disorders （79％） obtain improved neurological function. There was no intraoperative neurological damage caused by bone cement. The preoperative and postoperative 1 month VAS score were 8.02±0.51， 2.7±0.34， and the differences were statistically significant （P＜0.01）. Forty-four cases were followed up and 1 patient lost to follow. The durations of followed up ranged from 7 to 32 months， an average of 16 months. There were 35 cases died， including 3 cases within 6 months， 18 deaths in 7 to 12 months， 11 cases in 1 to 2 years， 3 cases in more than 2 years. Nine patients survived， 5 cases in 6 to 12 months， and 4 cases in 1 to 2 years. During follow-up， no bone cement sink， loose vertebrae collapse and angled forward was found. Conclusion The operation of posterior spinal canal decompression tumor resection within the fixation of a short segment pedicle screw and bone cement vertebral reconstruction under direct vision are simple and safe. It not only effectively relieve and reduce pain， but also maintain the stability of the spine， and provide a effective therapeutic method for improving the survival of patients with spinal metastatic tumor.