Objective To investigate the value of multi-slice spiral CT and its threedimensional (3D) reconstruction technique in the diagnosis and treatment of high energy induced vertebral burst fractures. Methods 160 patients with high energy induced vertebral burst fractures who were admitted to the hospital between January 2012 and January 2016 were selected as study subjects. All patients underwent multi-slice spiral CT cross-sectional images, its 3D reconstruction techniques and X-ray examination. The detection rates of different detection techniques for vertebral burst fractures and the accuracy rates in the diagnosis of fracture types were compared. Results A total of 180 vertebral burst fractures were detected by multi-slice spiral CT and 3D reconstruction techniques, involving vertebral segments T11, T12, L1, L2 and L3, and the numbers were 8, 50, 80, 32 and 10 respectively. There were 11 cases with multiple burst fractures. For the position of vertebral moving backward bone graft, it was found that the numbers of vertebral segments with single central bone graft, central sagittal fractures, bone graft deviate to one side of the spinal canal and comminuted bone graft were 78, 53, 38 and 11. For the source of moving backward bone graft, the numbers of cases from vertebral angle, posterior wall of the vertebral body and the lower corner were 101, 20 and 39. The numbers of cases with mild, moderate and severe spinal stenosis were 90, 60 and 10, and 90 cases received internal fixation. There were 60 cases with vertebral plate fractures, including left vertebral plate fractures, right vertebral plate fractures and bilateral vertebral plate fractures in 25, 10 and 25 vertebral segments. The detection rate of multi-slice spiral CT and its 3D reconstruction for vertebral fractures was 99.45%, and the accurate diagnosis rates of multiple vertebral burst fractures, bone grafts into the spinal canal and mild spinal stenosis were 91.67%, 99.45% and 100.00%, significantly higher than those of X-ray films (P<0.05). Conclusion Multi-slice spiral CT and its 3D reconstruction techniques can effectively improve the detection rate of high energy induced vertebral burst fractures and the accurate diagnosis rate of fracture types, which provides important references for implementation of targeted treatment measures.