The patient, Mr. Zou, suffered from low back pain due to a heavy object, had difficulty sitting up and turning over, and was unable to walk, and the imaging examination indicated a burst fracture of the T12 vertebral body with about 2/3 vertebral compression. Four 1.5-cm-long surgical channels were established in the thoracolumbar segment through dilators, and internal fixation with pedicle screws was performed in three segments, T11~L1, bilaterally, and bone grafting was performed via the pedicle after satisfactory repositioning of the T12 vertebral body fracture. Compared with traditional open surgery for thoracolumbar fractures, the paravertebral muscle interbody approach has the following advantages: (1) the exposure process is completed in the interbody, preserving the starting and ending points of the paravertebral muscles and reducing anatomical damage to soft tissues and intraoperative bleeding; (2) the integrity of the multifidus muscle is preserved, and the patient can start functional exercise early; (3) the posterior ligament complex is preserved intact, and at the same time, the conventional approach can achieve decompression and repositioning of the vertebral body; (4) the posterior ligament complex is preserved intact. (3) complete preservation of the posterior ligamentous complex while achieving conventional access decompression and vertebral body repositioning; (4) in line with the concept of minimally invasive surgery advocated nowadays, it can significantly relieve patients’ postoperative pain and shorten hospitalization time compared with traditional surgery.