The results of a consecutive series of 110 patients treated with the locking-hook spinal rod are presented. A prospective protocol was completed in 95 patients. Pain was absent or mild in 93%. In those patients with a partial neurologic deficit, there was recovery of at least one Frankel grade in 84%. The overall kyphotic deformity was reduced from 21 to 17.degree.. In those patients in whom no anterior surgery was performed, the deformity improved from 21 to 13.degree.. No rod fractures occurred, and the overall instrument complication rate was 13.7%, of which one was due to infection and four secondary to uncrimped nuts, for a true complication rate of 8.4%. The locking-hook spinal rod has proven to be a satisfactory internal fixation device in the treatment of unstable thoracolumbar fractures.