Percutaneous internal spinal nail fixation, or “minimally invasive surgery” as it is known in everyday life, is an internationally advanced surgical procedure for the treatment of spinal disorders such as lumbar spondylolisthesis, lumbar instability and thoracolumbar fractures. Compared with traditional open surgery, it has incomparable advantages: small intraoperative incision, less trauma and bleeding, and no extensive incision of soft tissues such as muscles and ligaments, thus avoiding delayed spinal instability caused by excessive stripping of muscles and soft tissues. Due to the small surgical trauma, the patient recovers quickly after surgery and can get out of bed early, which provides favorable conditions for the patient’s functional exercise and recovery after surgery. For thoracolumbar fractures, there were two treatment options in the past – one is conservative treatment, which allows the patient to be bedridden for 2-3 months and then gradually get down to the floor for rehabilitation exercises. Although this method does not require surgery, the recovery time is long, bedridden complications such as lung infection and bed sores are likely to occur, and patients are often left with lumbar lordosis and low back pain; the second is traditional surgery, in which a 15-20 cm long incision is made from the patient’s lumbar region, and the lumbar spine is “pinned” and “rods” are placed through the “rods” to achieve repositioning and fixation of the lumbar vertebrae, and after a year of complete repair, these fixation materials are then surgically removed. Minimally invasive percutaneous arch nail fracture repositioning and internal fixation. Four small incisions of about 1.5 cm in length are made in the patient’s back to complete the surgical operations of nail placement, repositioning and rod-piercing, which maximizes the integrity of the lumbar back muscles, reduces postoperative pain, surgical bleeding and incisional infection, and greatly shortens the patient’s recovery time. Patients are able to move on the floor after 3 to 4 days of bed rest. We have successfully performed this surgery for many patients with thoracolumbar fractures, with a 100% success rate. The following is a typical case: The patient, a 59-year-old female, suffered a compression fracture of the first lumbar vertebra with about 1/2 compression due to a fall from a height, and underwent closed reduction percutaneous internal fixation with an arch nail on December 6. He is now out of bed. Preoperative lateral radiographs intraoperative: incision: postoperative radiographs.