Objective To compare the clinical effect of posterior minimally invasive percutaneous and transforaminal approach pedicle screws in the treatment for thoracolumbar fractures. Methods Forty patients with thoracolumbar fractures who were treated in our hospital from June to February 2018 were selected as the research objects. They were divided into a control group (20 cases) and an observation group (20 cases) according to the random number table method. The observation group received minimally invasive percutaneous pedicle screw treatment, and the control group received transmuscular pedicle screw treatment. The surgical parameters such as the height of the anterior edge of the injured vertebrae, the Cobb angle of the sagittal vertebral kyphosis and the surgical efficacy of the two groups were compared. Results The height of the anterior edge of the injured vertebrae of patients of the two groups at 1 week and 6 months after surgery was greater than that in the group before surgery, and the Cobb angle of the sagittal vertebral kyphosis was smaller than that in the group before surgery, the differences were statistically significant (P＜0.05). There were no significant differences in the height of the anterior edge of the injured vertebrae and the Cobb angle of the sagittal vertebral kyphosis between the two groups before surgery, 1 week after surgery and 6 months after surgery (P＞0.05). There was no significant difference in the total clinical efficiency of patients between the two groups (P＞0.05).Conclusion Patients with thoracolumbar fractures undergo posterior minimally invasive percutaneous and transforaminal approach pedicle screws, which have high clinical effect, and surgical treatment can be selected according to the patient′s wishes.