Abstract: Objective To compare the effect of minimally invasive internal fixation and open reduction internal fixation on thoracolumbar spine fracture. Methods Total 150 cases of thoracolumbar spine fracture from May, 2016 to May, 2017 year in May in our hospital were selected and randomly divided into two groups, the control group received open reduction internal fixation treatment, while the study group received minimally invasive internal fixation, The surgical results, imaging indexes and VAS score were compared between the two groups. Results There was no significant difference in operation time between the two groups (P>0.05). The incision length, bleeding volume, postoperative drainage volume and hospitalization time in the study group were significantly lower than those in the control group (P<0.05);before the treatment, there was no significant difference in Cobb 's angle, anterior height of vertebral body and vertebral sagittal index between the two groups (P>0.05); after the treatment, Cobb's angle in the study group was significantly lower than that in the control group, however, the anterior height of vertebral body and vertebral sagittal index were significantly higher than that in the control group (P<0.05); there was no significant difference in visual analogue score (VAS) before the treatment between two group (P>0.05), however, VAS after the treatment at different time points in the study group was significantly lower than the control group (P<0.05). Conclusion Thoracolumbar spine fractures are usually induced by high energy force, and cauda equina and spinal cord can be affected in case of serious injury, the internal fixation can improve the clinical treatment effect and imaging index, reduce the pain of patients, worth to be popularized in clinic.