Lumbar compression fracture with severe endplate collapse can be treated with conservative therapy, surgical internal fixation and minimally invasive plasty. 1. Conservative treatment: mainly adapted to elderly thoracolumbar compression fracture. If there is no obvious decrease in muscle strength of the lower limbs, limb paralysis, bladder paralysis and other neurological injuries, lumbar dorsal muscle exercise can be used, which can help to maintain the stability of the spinal column, increase the strength of lumbar dorsal muscles, prevent the formation of scar tissue and adhesion due to the hematoma mechanization and avoid back pain in the future, and improve the interrelationships of the posterior joints, so that the patients can gradually adapt to the new situation after the fracture changes. 2. Surgical internal fixation: the pedicle root nail rod system belongs to the short-segment internal fixation device, which is suitable for the internal fixation of lower thoracic and lumbar vertebrae fracture. The purpose of surgery is to restore the stability and anatomical structure of the spine and to decompress and improve neurological function. Through the strong fixation achieved by the pedicle rod system, the normal sequence and physiological curvature of the spine is restored, the stability of the spine is rebuilt, and the effective decompression of the spinal canal creates an effective spinal volume for the recovery of spinal cord function. 3. Minimally invasive plastic surgery: The main mechanism of PKP and PVP (minimally invasive plastic surgery) is the structural filling of bone cement to strengthen the vertebral body and increase the stability of the diseased vertebral body, preventing the fracture from progressing and further collapsing and compressing the spinal cord, and effectively treating pain caused by microfractures. Specific treatments should vary from person to person, and different treatment options should be chosen according to the doctor’s recommendation depending on the individual’s condition.