7 studies (4 randomized control trials and 3 controlled studies) were included in this meta-analysis to determine the superior surgical treatment for burst fractures between anterior and posterior approaches. Functional and clinical outcomes were assessed in a total of 331 patients. The results of this meta-analysis indicate similar canal encroachment, Cobb angle, neurological function, and complication rates between treatments. The posterior approach was superior in operation cost and time. The limited quality of studies included should be noted as there is a need for further high-quality randomized trials on this topic.