This study aims to evaluate the effectiveness of various surgical strategies used in the management of complicated thoracolumbar spinal injuries accompanied by neural compression. A total of 176 patients were examined using clinical and advanced imaging methods. Three surgical approaches were compared: transpedicular fixation (TPF), decompressive laminectomy combined with TPF, and a comprehensive approach involving TPF, laminectomy, and postoperative electrical stimulation. The results demonstrated that the combined technique provided the most significant neurological improvement. These findings align with contemporary international and national research emphasizing the importance of early decompression and stable fixation in optimizing patient outcomes.