Patients who are victims of traumatic injuries in the spine are evaluated by radiological protocols, as recommended by Advanced Trauma Life Support (ATLS), including a computed tomography (CT) scan with the patient in the decubitus position. Spine fractures considered stable with initial nonoperative management should be further evaluated with a standard simple plain radiograph in orthostasis and/or a magnetic resonance image (MRI), to exclude any associated ligament injury and avoid neurological damage caused by occult instabilities. We present an illustrative case with an injury diagnosed through orthostasis X-ray to discuss its importance in the management of thoracolumbar fractures.