STUDY DESIGN: Retrospective study was performed in eight patients with Kummell disease. OBJECTIVES: To access the results of posterolateral decompression and posterior reconstruction in Kummell disease with neurologic deficits. SUMMARY OF LITERATURE REVIEW: Severe osteoporosis is the most frequent cause of spinal compression fracture. Vertebral compression fracture in senile osteoporosis is characterized by the late development and slow progression of paraplegia. When conservative treatment for paraplegia proves ineffective, an early operation is recommended. MATERIALS AND METHODS: From June 1996 to February 2000, eight consecutive Kummell disease patients with neurologic deficits underwent posterolateral decompression and posterior reconstruction. We analyzed operation time, loss of blood through the medical records. Change of segmental kyphotic angle, bone union were assessed by plain radiographs, the clinical results were analyzed according to changes of pain and neurological status. RESULTS: Mean operation time was 217 minutes, mean bleeding loss was 682 ml. The mean preoperative segmental kyphotic angle measured 22.6 degrees, and decreased to 4.4 degrees at postoperative evaluation, and 6.8 degrees at final follow-up. Bony union was obtained in 9 months. At preoperative time, four cases showed Frankel grade C and four cases Frankel grade D. At last follow-up time, one case Frankel grade D and six cases Frankel grade E. CONCLUSIONS: We concluded that posterolateral decompression and posterior reconstruction is a useful method for the treatment of Kummell disease with neurologic deficits.