Abstract:[Objective] To evaluate the clinical outcomes of pedicle screw fixation combined with bone grafting into the affected verte-bral body for thoracolumbar fractures. [Methods] A retrospective study was conducted on 55 patients who were treated with the above surgi-cal methods for thoracolumbar fractures from January 2018 to June 2022. After fixation and reduction with pedicle screw-rod system, target-ed puncture aimed the "cavity" of injured vertebrae was performed with bone cement puncture needle, and bone graft was implanted intothe vertebral body through the needle. Clinical and imaging data of the patients were evaluated. [Results] All the 55 patients were operatedon smoothly, without complications, such as nerve injury, while with satisfactory position of pedicle screw placed revealed by intraoperativefluoroscopy, operation time of (82.6±13.8) min and intraoperation blood loss of (51.5±15.7) ml. All the patients were followed up for (18.8±8.7) months on an average. Compared with that preoperatively, the VAS score significantly decreased 3 days postoperatively and at the lat-est follow-up [(7.2±1.3), (2.0±1.3), (1.0±1.3), P＜0.001]. Radiographically, the vertebral body compression ratio [(42.6±9.6)%, (2.1±1.5)%,(3.2±0.9)%, P＜0.001] and local kyphotic Cobb angle [(24.1±5.5)°, (3.0±2.2)°, (3.2±2.1)°, P＜0.001] significantly reduced. At the last followup,all the injured vertebral body got bony healing without obvious loss of vertebral height, and no loosening or fracture of internal fixationdevices. [Conclusion] The pedicle screw fixation combined with bone grafting into the affected vertebral body for thoracolumbar fracturesdoes obtain more stable fracture reduction and fixation to avoid vertebral height loss.