Objective To study the clinical effect of poking reduction and bone graft on the treatment of thoracolumbar vertebral compression fracture. Methods All of 49 patients who had single segment of thoracolumbar compression fracture underwent operation in the period of October 2010 to August 2012. According to the operation methods, they were divided into 2 groups.Group A (23 patients) underwent poking reduction and bone graft treatment. Group B (26 patients) received short segment pedicle screw fixation. The VAS score, recovery of vertebral body, improvement of Cobb angle, operative time, and blood loss were compared between them. Results All operations were successful without spinal cord and nerves injury. The postoperative follow-up ranged 14-26 months. At 1 week after the operation and at the final follow-up, both of the 2 groups had significant difference in average vertebral height,local Cobb angle, and VAS score when compared with pre-operative level(P<0.05). But group A had advantage in vertebral height restoration, kyphosis angle rectification and VAS score improvement (P<0.05). Conclusions As an effective method for treating thoracolumbar vertebral compression fracture, poking reduction and bone graft have the characteristic of reducing vertebral height loss and avoiding the shell-like vertebral development.