The use of the lap type safety belt has been shown by numerous studies to be effective in the reduction of major and fatal automobile injuries. But when the belt is loosely worn or intentionally placed higher on the abdomen, entirely different force is created especially flexion distraction force. It is inevitable that in some instances these forces will exceed the stress resistance of these musculoskeletal parts and produce fractures, dislocations, or both of thoracolumbar spine. The authors have reviewed 20 cases of the seat belt injuries from January, 1984. to December, 1990. Follow-up period for these cases was more than 1 year. The results were obtained as follows; 1. Majority of the patients was in an active age group and more common in males. 2. The most frequently injured level was L1 and by Francis Denis classification, subtype A was the most common. 3. The average preoperative kyphotic angle was 17.5° and postoperative was 10.0° 4. Remarkable neurologic recoveries were observed in cases of incomplete cord lesion. 5. Orthopedic surgeons must be aware of the increased use of seat belts and the consequence of the injury patterns related to their use.