Steel bar penetrating injury of rectum and vertebral body can be severe and cause complex injuries. Complications included infection and cerebrospinal fluid fistula. Thorough history and physical examination and CT and MRI inspection are very important for timely diagnosis and early treatment of spine and cauda equina injuries. Dural tear should be carefully inspected and repaired during posterior lumbar decompression surgery. Cooperation of experienced surgeons from orthopedics and gastrointestinal department is needed to give the patient the most appropriate treatment and improve prognosis.