For a thoracolumbar junction lesion, there are many approaches according to pathology. A combined anterior and posterior approach can give anterior and posterior fixation with adequate neural decompression in three column lesion like a metastatic tumor or primary malignant lesion. But it can cause a serious complication of vascular or visceral injury especially during anterior approach. Author developed a new approach which can give a rigid fixation at anterior and posterior column simultaneously by posterior approach. This method has advantages of both anterior and posterior approach and associated with minimized postoperative morbidity. By this method good three column stabilization and adequate neural decompression can be achieved immediately. Three cases of malignant spinal tumors and two cases of complicated spine fracture were operated by this approach. Among three tumor cases, two patients showed rapid recovery of their impending paraparesis. All patients had excellent clinical results and good stabilities of spinal column without any complications.