Background: Fractures of the thoracolumbar (TL) vertebrae are common. Optimal surgical management aims to enhance movement and provide long-term stability. Short segment posterior spinal fixation (SSPSF) provides better movement, has less economic burden, but superiority over long segment posterior spinal fixation (LSPSF) remains uncertain. The aim of this study was to report the difference between SSPSF versus LSPSF with regards to loss of correction measured with Cobb's angle in patients with single level unstable burst TL vertebral fractures. Methods:This was a retrospective cohort study including patients who presented between August 2012 to July 2015 at King Saud Medical City, Saudi Arabia-a level I trauma centre. Cobb's angles were measured by two independent assessors immediately post-operative and at one-year follow up. The differences in Cobb's angles were compared for all included patients, and in subgroups of patients that underwent fusion and in the subgroup of patients that underwent LSPSF only.Results: There were 39 patients included with a burst type fracture and completed 1-year follow-up. Ten patients underwent SSPSF and 29 underwent LSPSF. The mean age was 35 (SD 15.7) years, the most common mechanism of injury was a motor vehicle crash (32; 85.1%) and the L1 (20; 51.3%) was the most commonly injured vertebra. Among patients who underwent SSPSF, Cobb's angles were significantly higher immediately post-surgery (9.0 vs. 0.35 degrees; p < 0.001) and at 1-year after surgery (16.5 vs. 3.46 degrees; p < 0.001). Change in Cobb's angle at 1-year follow-up was 7.5 (SD 3.6) degrees among SSPSF group, compared to 3.1 (SD 4.8) degrees in the LSPSF group (p < 0.001). The differences persisted when patients who underwent SSPF were compared to those that underwent LSPSF without fusion. Among patients who underwent LSPSF, no differences were observed between those who underwent fusion versus those that did not. Conclusion:LSPSF appeared superior to SSPSF for maintaining Cobb's angle at 1-year post-surgery. Further research on parameters describing clinical and patient reported outcomes following different fixation modalities are needed to determine the most appropriate surgical technique.