Objective To study the therapeutic effect of vertebral pillar block insertion through vertebral pedicle in treatment of thoracolumbar vertebral fractures. Methods The study involved 23patients (25 vertebrae and 47 vertebral pillar blocks) with thoracolumbar vertebral fractures treated with vertebral pillar block insertion through vertebral pedicle in our hospital from March 2008 to July 2009.There were two patients with T11 fractures, nine with T12 fractures, seven with L1 fractures and five with L2 fractures (four patients were treated with decompression by fenestration between vertebral plates and vertebral pedicle fixation with vertebral pillar block). Surgical operation, operation duration, blood loss during operation, postoperative and follow-up X-ray films were observed, and the ratio of anterior vertebral height and normal height, degree of Cobb angle correction and early postoperative recovery were determined. Results Twenty-three patients were followed up for 7-16 months (mean 12.5 months),which showed little postoperative vertebral height loss and significantly improved postoperative anterior vertebral compression rate and the Cobb angle (P ＜ 0. 05). Conclusions Vertebral pillar block can effectively restore the mechanical properties of vertebral bodies, reduce further loss of vertebral height,kyphosis reproduction and other complications and take advantages of shorter operative time, less bleeding, faster recovery and better adaptation to the biological fixation in treatment of thoracolumbar vertebral fractures.