Magerl first reported percutaneous pedicle screw fixation with an external fixation device for the treatment of thoracolumbar fractures in 1982, and several other publications have described similar techniques. The emergence of the percutaneous pedicle screw technique has avoided the disadvantages of large incisions, muscle stripping, and slow postoperative recovery associated with traditional posterior spinal internal fixation implantation, and it has gradually become one of the basic techniques of minimally invasive spinal surgery. With the development of built-in objects, surgical instruments and imaging, the use of percutaneous internal fixation has been gradually carried out in clinical practice. Selection of patients for surgery: (1) single-segment thoracolumbar burst fractures; (2) bilateral intact pedicles, no displaced bone masses in the spinal canal, and at least one intact endplate; (3) no clinical signs of neurological damage (4) age less than between 60 years; (5) exclusion of pathological factors such as osteoporosis or tumor causing the fracture; Surgical approach: general anesthesia, prone position, abdominal suspension. The injured vertebra in the thoracolumbar segment is repositioned by appropriate dorsal to ventral pressure posterior extension and monitored under fluoroscopy by c-arm x-ray machine for recovery of anterior and middle column height of the injured vertebra. The injured vertebra and the adjacent vertebral arch projection on the injured side of the endplate were located and marked with electrofluoro. A disinfected towel is spread and a jamshidi puncture needle is used to locate and reach the pedicle at a point 0.5 cm out from the marker (approximately 4 cm from the midline), and the angle of the puncture needle is adjusted under c-arm machine fluoroscopy to avoid the fracture line and to point to the intact side of the endplate through the pedicle into the vertebral body. After placing it at the junction of the tuberosity and the transverse process, it can be partially penetrated into the arch, when using anteroposterior fluoroscopy it can be shown that the tip of the needle is located at the outer edge of the arch at the point of entry (2 and 10 o’clock positions) and is penetrated 1.5-2.0 cm downward, after the jamshidi needle has passed through the arch, the tip of the needle should be close to the medial wall of the arch in frontal fluoroscopy; in lateral fluoroscopy, the tip should be In lateral fluoroscopy, the tip of the needle should be close to the base of the vertebral arch. The needle is fixed in position and the outer sleeve of the needle is removed. The skin and lumbar dorsal fascia are incised about 1.5 cm from the guide-needle puncture point, and the initial dilator is placed in the direction of the guide-needle and electrically fluoroscoped to determine its position. The hollow dilator is left in place, and the wire tapping is screwed along the guide needle into the vertebral arch to the anterior column of the vertebral body. The guide pin is fixed and the tapping is removed, and the hollow screw is screwed in. The same method is used to place the pedicle nail on the other side and on the adjacent vertebral body on the injured side of the endplate. Select a fixation rod of appropriate length and angle, insert it along the soft tissue channel, determine under fluoroscopy that the fixation rod passes through each pair of retractor blades, and lock the screw cap. c-arm x-ray machine to confirm the position of each screw, if the anterior column support is not enough to properly compress the retractor, and finally tighten the screw cap after the height of the anterior column is restored. The incision is flushed with a large amount of saline and no negative pressure drainage is left in place. Puncture procedure: Typical case: male, 54 years old, 3M fall from height, lumbar pain came to hospital, no neurological symptoms, imaging L1 vertebral fracture with fragmentation of the upper endplate, minimally invasive percutaneous pedicle screw single-segment internal fixation was performed under general anesthesia after coming to hospital, the patient recovered well after the operation and went down to functional exercise earlier under the protection of brace.