60 patients with thoracolumbar spinal fractures were randomized to receive pedicle screw fixation via either a minimally invasive or open fixation technique. Outcomes of interest included operative time, radiation time, length of stay, blood loss, the anterior height ratio of the fractured vertebral, Cobb angle, and back pain on a Visual Analog Scale (VAS). Final follow up was performed at a mean of 15.4 months after operation. Results revealed significantly favourable operative time, blood loss, length of hospital stay and VAS back pain score 3 days post-operation in the minimally invasive group compared to the open fixation group. Radiation time was significantly longer in the minimally invasive group compared to the open fixation group. No significant differences in anterior height ratio of the fractured vertebrae, Cobb angle, or VAS back pain at final follow-up were observed between the two groups.