To explore long-term effect of percutaneous pedicle screw fixation in the treatment of thoracolumbar fractures. Methods A total of 124 patients with thoracic and lumbar spine fractures admitted to our hospital from June 2018 to June 2020 were selected and divided into observation group and control group with 62 cases each, according to different surgical plans. The observation group was fixed with minimally invasive percutaneous pedicle screw fixation for treatment, and the control group was treated with traditional open pedicle screw internal fixation. The operation time, intraoperative blood loss, incision length, hospital stay, imaging indicators, and postoperative functional recovery were compared between the two groups. Results In terms of perioperative surgery-related indicators, the observation group and the control group were significantly lower (P＜0.05). In terms of imaging indicators, the height of the anterior edge of the injured vertebra in the two groups at 1d, 12 months, and 24 months after operation was higher than that before operation, and the Cobb angle was lower than that before operation, and the difference was significant (P＜0.05). On the first day after the operation, the height of the anterior vertebral edge in the observation group was significantly higher than that in the control group, and the Cobb angle was significantly lower than that in the control group (P＜0.05). There was no significant difference in the above indicators between the two groups at 12 months and 24 months after operation (P＞0.05). In terms of lumbar spine function, the ODI index of the two groups at 6 and 12 months after surgery was significantly lower than that before the operation, and the degree of reduction in the observation group was significantly better than that of the control group (P＜0.05). In terms of pain, the VAS scores of the two groups at 1 week, 6 months, and 12 months after surgery were significantly lower than those before surgery, and the VAS score of the observation group was significantly lower than that of the control group at 1 week after surgery (P＜0.05). In terms of postoperative complications, there was no significant difference in the total incidence between the two groups (P＞0.05).Conclusion Minimally invasive percutaneous pedicle screw fixation for patients with thoracolumbar fractures can achieve satisfactory clinical results. It has the advantages of less trauma and recovery, which can further reduce pain and improve lumbar spine function. The long-term effect is significant and safe