ObjectiveThe aim of this study was to explore the diagnostic value of 64-slice spiral CT and its reconstruction techniques for thoracolumbar compression fractures.MethodsA retrospective analysis was performed on the clinical data of 98 patients with thoracolumbar compression fractures who were admitted to the hospital between May 2018 and December 2020. All patients received 64-slice spiral CT and digital radiography (DR) examinations. Using surgical results as the gold standard, the examination results of 64-slice spiral CT and its reconstruction techniques were compared with those of DR.ResultsDR examination found that all patients had vertebral compression fractures. Lumbar spine orthotopic films showed different degrees of decline in the vertebral height. Lumbar spine lateral films showed that the vertebral body was compressed or biconcave. The images of hyperflexion and hyperextension showed openings. Some patients’ images showed signs of vacuum in the intervertebral disc. Examination of the 64-slice spiral CT scans found that the patients’ fracture lines were clear and sharp, with paravertebral soft tissue shadows. Some patients’ images showed signs of vacuum in the intervertebral disc, contusion and bleeding of the spinal cord, contusion and laceration of the perivertebral organs, and trabecular structure disorder and sclerosis of the vertebrae. For all patients with thoracolumbar compression fractures, 137 fractured vertebral bodies were confirmed by surgery, 122 fractured vertebral bodies (89.05%) were detected by DR, and 131 fractured vertebral bodies (95.62%) were detected by multi-slice spiral CT. The detection rates of fractured vertebral bodies by the two methods showed a significant difference (P<0.05). A total of 195 fractures occurred in 137 fractured vertebral bodies. The detection rate of the fracture sites by DR was significantly lower than by multi-slice spiral CT (P<0.05). The detection rates of transverse process and lamina fractures by DR were lower than by multi-slice spiral CT (P<0.05). There were no significant differences in the detection rates of spinous process, facet joint, and pedicle fractures between the two methods (P>0.05).Conclusion64-slice spiral CT and its reconstruction techniques exhibit good diagnostic value for thoracolumbar compression fractures. This technique can significantly improve the diagnostic accuracy for thoracolumbar compression fractures.