Background: The spine is made of 33 individual bones stacked one on top of the other. This spinal column provides the main support for your body, allowing you to stand upright, bend, and twist as well as protecting the spinal cord from injury. Objective: The aim of this study was to evaluate the post-operative clinical outcome of transpedicular screw and rod fixation in unstable thoracolumbar fractures by using Mc Nab's criteria in patients collected from Sohag General Hospital and Sohag University Hospital. Patients and methods: A prospective study included patients admitted to Orthopedic and Traumatology Department of Sohag General Hospital suffering from unstable fracture of thoracolumbar area. The study was conducted on twenty patients suffering from thoracolumbar fractures attending to Department of Orthopedics and Traumatology, Sohag University Hospitals, Sohag General Hospital and Al-Azhar University Hospitals from June 2018 till December 2018. Results: In comparison between cases, which conserved and those operated as regard vertebral height loss, angle of kyphosis, oswestry disability index and visual analogue score, we found that p value was not significant in these parameters and its value was 0.15, 0.46, 0.15, and 0.88 respectively. Which means that decision making correlated to patient score. As regards type of operative fixation done, there were non-significant comparison between type of fixation done and the mentioned parameters. All changes in the parameters explain that these parameters correlate with TLICS and prove the validity of this classification. Conclusion: Posterior short segment pedicle screw fixation is good and enough for treatment of thoracolumber fractures (burst fracture) when neurological condition of the patients is intact.