Objective To explore the effects of pedicle bone grafting assisted treatment on oxidative stress response and pain mediators in patients with spinal fractures. Methods 82 cases of spinal fractures treated at the First People's Hospital of Zhumadian City from January 2022 to September 2024 were randomly divided into the internal fixation group (41 cases) and the bone grafting assisted group (41 cases), and the grouping method used was a random number table method. The treatment method used in the internal fixation group was posterior surgery with internal fixation and fusion (PLIF). On the basis of the internal fixation group, the bone grafting assisted group received assisted treatment with pedicle bone grafting in the vertebral body. The follow-up time for both groups after surgery was 1 month. The surgical related indicators, pain, lower back dysfunction, daily activity ability, spinal cord function before and 2 weeks after surgery, oxidative stress response, and pain mediators before and 1 month after surgery. Results There was no statistically significant difference in surgical related indicators between the two groups (P>0.05). Compared with before surgery, the scores of in Visual Analog Scale (VAS), Oswestry Disability Index (ODI) in both groups 2 weeks after surgery, all decreased, and and the scores of VAS, ODI of the bone grafting assisted group were (3.54 ± 0.76) points, (9.76 ± 1.02) points, respectively, which were lower than those of the internal fixation group (4.87 ± 0.80) points, (15.76 ± 1.73) points; The Barthel index increased in both groups increased, and the Barthel index in the bone grafting assisted group were (92.02 ± 2.43) points, which was higher than the internal fixation group (81.78 ± 2.38) points (P<0.05). Compared with before surgery, the proportion of Frankel grade D spinal cord injury patients in the bone grafting assisted group and grade E patients in both groups 2 weeks after surgery increased, and the proportion of D-grade and E-grade patients in the bone grafting assisted group were 36.59% and 36.59%, respectively, both higher than the internal fixation group's 17.07% and 21.95%, respectively (P<0.05). Compared with before surgery, the levels of serum angiotensin II (Ang II), substance P (SP), dopamine (DA), and 5-hydroxytryptamine (5-HT) in both groups 1 month after surgery, all decreased, and and the levels of serum Ang II, SP, DA, and 5-HTof the bone grafting assisted group were (110.02 ± 10.87) mmol/L, (111.54 ± 9.87) ng/mL, (10.03 ± 0.81) ng/mL, and (694.54 ± 39.87) ng/mL, respectively, which were lower than those of the internal fixation group (126.32 ± 10.24) mmol/L, (184.21 ± 10.65) ng/mL, (13.25 ± 0.99) ng/mL, and (717.65 ± 43.65) ng/mL; The levels of serum glutathione peroxidase (GSH Px), advanced oxidative protein products (AOPP), β - endorphin (β - EP) 2 increased in both groups increased, and the Barthel index and levels of serum GSH Px, AOPP, and β - EP in the bone grafting assisted group were (250.54 ± 20.35) mg/L, (37.02 ± 3.57) mg/L, and (226.43 ± 16.02) pg/mL, which was higher than the internal fixation group (229.65 ± 17.21) mg/L, (26.09 ± 4.87) mg/L, and (187.87 ± 14.87) pg/mL (P<0.05). Conclusion Pedicle bone grafting assisted treatment did not prolong the surgical and hospitalization time of patients with spinal fractures, and had no significant effect on surgical incision, intraoperative bleeding, postoperative drainage, etc. It could effectively reduce postoperative pain, oxidative stress response, and lower back dysfunction, improve spinal cord function and daily activity ability, and had high clinical promotion value.