Objective To investigate the effect of percutaneous pedicle screw on thoracolumbar spinal fracture. Methods A total of 326 patients with thoracolumbar spinal fractures treated in our hospital from January 2017 to September 2019 were randomly divided into two groups: traditional group (163 cases, treated with traditional open pedicle screw fixation) and minimally invasive group (163 cases, treated with percutaneous pedicle screw fixation). The effects of the two groups were compared. Results The amount of intraoperative bleeding in the minimally invasive group was significantly less than that in the traditional group (P<0.05), and there were no significant differences in operation time and excellent and good operation rate between the two groups (P>0.05). After treatment, the VAS and ODI scores of the two groups were significantly improved, and the scores after treatment in the minimally invasive group were significantly lower than those in the traditional group (P<0.05); the incidence rate of complications in the traditional group was significantly higher than that in the minimally invasive group (P<0.05). Conclusion The short-term effect of percutaneous pedicle screw fixation is similar to that of traditional open surgery, but it can significantly improve the recovery of postoperative thoracolumbar function and reduce postoperative pain and complications, which is worthy of clinical promotion.