[Objective] To observe the clinical outcomes of thoracolumbar burst fractures treated by individualized unilateral pedicle screw fixation for the fractured vertebra combined with transpedicular interbody bone grafting. [Methods] A retrospective study was performed on 60 patients who received posterior short-segment instrumentation with unilateral pedicle screw fixation for thoracolumbar burst fractures from April 2016 to February 2018. In term of the different treatment of the fractured vertebra, they were divided into two groups, including the grafted group in which 30 patients had fracture fixed with individualized unilateral pedicle screw fixation for the fractured vertebra combined with transpedicular interbody bone grafting, and the non -grafted group in which 30 patients received posterior short-segment instrumentation with routine unilateral pedicle screw fixation.The clinical data were compared between the two groups.. [Results] The operation time of the grafted group was longer than that of the non-grafted group, the difference was statistically significant(P<0.05).There were no statistically differences of blood loss and incision length between two groups (P>0.05). All patients were followed up for 12 to 33 months with a mean of (20.36?8.28) months. The vertebral compression rate and Cobb angle after operation in both groups were significantly better than those before operation, and the difference was statistically significant (P<0.05),There was no significant difference between the two groups at 1 week after operation (P>0.05),At the last follow-up, in the grafted group were significantly better than those in the non-grafted group, and the difference was statistically significant (P<0.05). The VAS scores in the two groups at each time point after operation was significantly improved compared with that before operation (P<0.05), and there was no significant difference at the same time point (P>0.05). There were 6 cases of “shell” phenomenon in the grafted group and 24 cases in the non-grafted group, there was a significant difference between the two groups (P<0.05). No internal fixation loosening or breaking happened in any patient of the grafted group, while 4 cases of pedicle screw root breakage and 3 cases of connecting rod breakage in the non-grafted group, and the difference was statistically significant (P<0.05). [Conclusion] Individualized unilateral pedicle screw fixation for the fractured vertebra combined with transpedicular interbody bone grafting does achieve stronger fixation for thoracolumbar burst fracture than posterior short-segment instrumentation with routine unilateral pedicle screw fixation, which effectively restore and maintain the height and Cobb angle of the fractured vertebrae,increasing bone healing rate, significantly reduce the secondary compression and kyphosis of the fractured vertebrae after operation.