Minimally invasive is the soul of contemporary surgery, aiming to achieve therapeutic results while minimizing tissue trauma. In spine surgery, minimally invasive is also both a relentless pursuit of surgeons and a strong desire of patients. Minimally invasive is not only a technique, but also a concept. In the field of thoracolumbar spine fracture treatment, surgery is required to restore and maintain the normal sequence of the spine, reestablish spinal stability through fracture healing, and, if necessary, decompression of neural tissue and spinal fusion. These surgical objectives cannot be accomplished with only one or two special instruments, and the spinal tissues have different tolerance to trauma. For “minimally invasive” requirements, nerve tissue > bone tissue > muscle tissue > skin. In other words, if the nerve tissue is not adequately decompressed or mistakenly injured, if the normal sequence of the spine is not adequately restored, or if the spinal fusion is not carried out instead of bone graft fusion, or if the surgical operation damages the muscular tissues too much, then even if the skin incision is too small and even if special minimally invasive instruments are used, the operation cannot be called a truly minimally invasive surgery. In our hospital, we routinely use transosseous approach to treat patients with thoracolumbar spine fracture without nerve injury, which achieves good results with small incision, little muscle injury, less bleeding, effective restoration of the normal spinal sequence, and accurate nailing to reduce the probability of nerve injury.