Introduction: The majority of musculoskeletal injuries around the globe are spine fractures. The thoracic and lumbar spine account for 75–90% of fractures of the spine. Aim of study: To compare the radiological and clinical results of short segment with index vertebra fixation with those of long segment fixation, in the cases of thoracolumbar fractures. Patients and methods: This interventional comparative study included 40 patients with traumatic thoracolumbar fractures, of these 20 patients underwent short segment open transpedicular posterior with index vertebral fixation and 20 patients underwent long segment open transpedicular posterior fixation. Results: The operative time in Short Segment with Index Vertebra Fixation (SSIVF) was 149 minutes taking considerably less time than Long Segment Fixation (LSF) (195 minutes). Blood loss was significantly less in SSIVF (290.5 ± 94.88 mL.) than in LSF (495.5 ± 110.76 mL). Regarding postoperative visual analogue scale (PVAS) pain was significantly lower in SSIVF (2.25 ± 1.45) group than in LSF group (4.6 ± 1.79) and Oswestry Disability Index (ODI) was significantly lower in SSIVF group (20.4 ± 12.1) than in LSF group (26.05 ± 13.45) follow-up after 12 weeks postoperatively. Angl of Kyphosis measured by Cobb angle in LSF group (7.7 ± 2.030) correction was significantly best than in SSIVF group (9.3 ± 2.25) Follow-up after 12 weeks postoperatively. Conclusion: In comparison with LSF technique, the SSIVF technique yielded significantly better clinical and functional outcomes for PVAS and ODI. Compared to the SSIVF procedure, the LSF technique greatly outperformed of radiological correction of Cobb's angle at the most recent follow-up.