Abstract: Objective：To compare the clinical values of minimally invasive Wiltse approach and conventional posterior approach for the treatment of thoracolumbar vertebral fractures. Methods：From November 2010 to June 2014, the pedicle screwrod fixation system was used to treat thoracolumbar fractures (AO type A) in 50 patients. Among them, 28 cases were treated by minimally invasive Wiltse approach, and other 22 cases were treated by conventional posterior median approach. Based on American Spinal Injury Association (ASIA) grading standards, the spinal cord injury function of all cases were grade E before operation. All fractures were singlesegment fracture, including T11 in 4 cases, T12 in 10 cases, L1 in 26 cases, and L2 in 10 cases. The time from injury to operation varied from 2 to 13 days (mean, 4.9 days). Perioperative parameters, visual analogue scale (VAS) score of postoperative pain and the kyphotic Cobb angle of vertebral bodies for evaluating the correction effect were recorded and analyzed. Results：All cases were followed up for 1226 months (mean, 15 months). The operation time, hospital stay, intraoperative blood loss, and postoperative drainage volume in the group of minimally invasive Wiltse approach were significantly less than those in the group of conventional posterior midline approach (P<0.05). The VAS scores in minimally invasive Wiltse approach group were significantly less than those in conventional approach group in 24 and 48 hours after operation (P<0.05). Cobb angles of the two groups were obviously recovered after operation as compared with those before operation (P<0.05), but there were no significant differences between the two groups before and after operation (all P > 0.05). Conclusions：For the thoracolumbar vertebral fractures (AO type A, ASIA grade E), compared with the conventional approach, minimally invasive Wiltse approach has the advantages of less surgical traumas, less vertebral side tissue injury, easy for pedicle screw insertion, light postoperative lumbar back pain, and effective correction of kyphosis deformity. It is suggested that minimally invasive Wiltse approach is worth to be popularized in remote areas for the treatment of thoracolumbar fractures.