Purpose: Traumatic diaphragmatic hernia associated with the spine fracture were few reported.The thorougbly understanding this kind of injury would be benefit for the early diagnosis and treatment avoiding delayed or missed diagnosis.The objective of this study was to explore the potential clinical characteristics and mechanism of TDH combined with the spine fracture.Methods: Eighteen TDH patients, were included in this retrospective in our centre between July 1987 and September 2012.All cases of penetrating injury of the diaphragm were excluded.The etiological factors, injnry mechnism, diagnosis, and other factors were analyzed and discussed.Results: The mean age was 34.7 years with a female to male ratio of 1/17.TDH was right-sided in 5.6% (n =1)and left-sided in 94.4% (n =17).The cause of the diaphragmatic cupture was crush injury 15 (83.3%), and free fall trauma in 3 (16.7%).Only five patients (27.8%) had late diagnosis.Associated injuries were seen in 88.9% (n =16)of the patients.Morbidity and mortality were encountered in 72.2% (n =13) and 5.6% (n =1) patients, respectively.Conclusions: Although the spine fracture accompanied with traumatic diaphragmatic hernia is very rare,diaphragmatic hernia must be suspected in any patient with spinal fracture, especially for thoracolumbar fracture.Early diagnosis of TDH is sometimes difficult and depends on a high index of suspicion.The diaphragmatic hernia was easily missed for months to years after the injury.Most diaphragmatic ruptures occur in the left posterolateral aspect of the diaphragm.The spinal fractures should be treated concurrently with diaphragmatic hernia.