Abstract: [Objective] To compare the effect of bone cement-augmented short-segment pedicle screw system (SPSS) fixation and percutaneous kyphoplasty (PKP) in the treatment of osteoporotic thoracolumbar burst fractures. [Methods] A retrospective study was made on 91 patients who received surgical treatment for osteoporotic thoracolumbar burst fractures in our hospital from January 2016 to January 2019. Based on the different surgical methods,42 patients underwent cement-augmented SPSS fixation as SPSS group, while 49 patients underwent PKP as PKP group. The perioperative conditions and complications were compared between the two groups. The visual pain analog scale (VAS) score, Oswestry dysfunction index (ODI) and imaging parameters were evaluated. [Results] The intraoperative bleeding and operation time in SPSS group were higher than those in PKP group (P<0.05), but there was no significant difference in postoperative hospital stay and complication rate between the two groups (P>0.05). At the last follow-up, the improvement rate of VAS score and ODI score in the SPSS group were higher than those of the PKP group (P<0.05). At the last follow-up, the correction rate of Cobb angle, height of the anterior edge and posterior edge in the SPSS group were higher than those of the PKP group (P<0.05). [Conclusion] The correction effect of bone cement-augmented short-segment pedicle screw system fixation is better than PKP for patients with osteoporotic thoracolumbar burst fractures, which can better relieve pain and improve spinal function.