Objective The purpose of this study was to investigate the clinical value of CT three-dimensional reconstruction technology in measuring the pedicle width (PW) of patients with osteoporotic vertebral compression fracture (OVCF) and young and middle-aged patients with traumatic thoracolumbar fractures (T11-L5). Methods The data of 117 patients with thoracolumbar fractures who were admitted to the hospital from October 2020 to October 2022 were analyzed retrospectively. Patients with OVCF (n=65) were defined as group A. Young and middle-aged patients with traumatic thoracolumbar fractures (T11-L5) (n=52) were defined as group B. The PW of T11-L5 corresponding vertebrae was measured by CT three-dimensional reconstruction technology. The bilateral PW was compared between the two groups, and between patients of different gender. The percentages of PW smaller than 5 mm and smaller than 7mm were calculated. Results The right and left PW of corresponding vertebra in group A showed no significant difference (P>0.05). The PW values of T11-L5 corresponding vertebrae in group A were lower than those in group B (P<0.05). The PW values of T11-L5 corresponding vertebrae in males were higher than those in females in each group (P<0.05). The PW values of T11-L3 corresponding vertebrae in males and females in group A were lower than those in group B (P<0.05). The PW values of L4 and L5 vertebrae in the two groups were similar (P>0.05). A total of 655 pedicles were measured in group A. Pedicles with PW smaller than 5 mm accounted for 7.48%, which were mainly distributed in T11-L3 vertebrae. Pedicles with PW smaller than 7 mm accounted for 37.25%, which were mainly distributed in T11-L4 vertebrae. A total of 359 pedicles were measured in group B. Pedicles with PW smaller than 5 mm accounted for 1.67%, which were mainly distributed in T12-L2 vertebrae. Pedicles with PW smaller than 7mm accounted for 13.09%, which were mainly distributed in T11-L3 vertebrae. Conclusion PW values of T11-L3 in elderly patients with OVCF are significantly lower than those in young and middle-aged patients. PW values of T11-L3 in females are lower than those in males. Therefore, patients with thoracolumbar fracture should be examined with CT three-dimensional reconstruction to measure PW so as to evaluate the feasibility of surgical treatment and reduce complications