Abstract: Objective:To investigate the clinical effects between posterior paraspinal muscle approach and conventional posterior middle approach in the treatment of thoracolumbar burst fractures.Methods:The clinical data of 60 thoracolumbar burst fractures patients followed by more than 6 months were retrospectively analyzed.Thirty cases were treated with posterior paraspinal muscle approach(observation group),and 30 cases were treated with conventional posterior middle approach(control group).The operative time,peroperative bleeding,and postoperative drainage,VAS score,anterior height of vertebral body and Cobb angle between two groups were compared,which was used to evaluate the treatment effects of two approaches.Results:The operative time,peroperative bleeding and postoperative drainage in observation group were significantly less than those in control group(P<0.01).The VAS score in observation group was significantly lower than that in control group 1 week and 6 months after operation(P<0.01).The differences of the anterior height of vertebral body and Cobb angle 1 week and 6 months after operation between two groups were not statistically significant(P>0.05).Conclusions:The treatment effect of thoracolumbar burst fracture with posterior paraspinal muscle approach and conventional posterior middle approach are ideal.The treatment of posterior paraspinal muscle approach is less bleeding,injury and pain,which is worthy of promotion in clinic.