Abstract: [Objective] To compare the clinical results of mono-segment fixation and short segment fixation in the treatment of mild thoracolumbar fracture. [Methods] A total of 62 patients with mild thoracolumbar fracture admitted from January 2019 to July 2021 were prospectively compared, and randomly divided into 2 groups, 32 cases with single level fixation and 30 cases with short level fixation. Perioperative period, follow-up and imaging data of the two groups were compared. [Results] All patients successfully completed the operation. All patients were followed up for at least 12 months, with an average follow-up of 16.3±4.5 months. The operation time, incision length and intraoperative bleeding in the mono-segment group were all smaller than those in the short segment group (P<0.05). The VAS score, walking time and full weight-bearing time of the mono-segment group were earlier than those of the short segment group one week after surgery (P<0.05), and the ODI score of the last follow-up was lower than short segment group (P<0.05). [Conclusion] Mono-segment fixation in the treatment of mild thoracolumbar fracture has the advantages of less exposure, less operative time, less intraoperative bleeding, which can achieve sufficient stability and excellent therapeutic effect.