Objective To investigate the effect of vertebral pedicle screw fixation on the spinal stability and low back pain in the treatment of thoracolumbar fracture. Methods 75 patients with thoracolumbar vertebral compression fractures in department of orthopedics of our hospital from May 2015 to May 2018 were selected and divided into two groups according to the internal fixation method. 41 patients in the control group were treated with inter-vertebral screw fixation, while 34 patients in the observation group received the vertebral pedicle screw fixation. Then the repair effect, anterior vertebral height, the Cobb angle, and the visual analog scale (VAS) score were compared between the two groups. Results The pre-treatment and post-treatment anterior vertebral height, the Cobb angle and the repair effect had no difference between groups (P＞0.05), while the anterior vertebral height and the Cobb angle of the observation group were better than those of the control group during the last follow-up (P＜0.05). The pre-treatment and posttreatment VAS score had no difference before treatment (P＞0.05); The VAS score of pretreatment and last follow-up as well as the post-treatment and last follow-up within groups had statistic difference (P＜0.05). The total incidence rate of the complications was 1408% (10 cases). Conclusion The application of the vertebral pedicle screw fixation has the dominance in maintaining the height and curvature of the spine, and is more effective in the stability reconstruction and the low back pain control.