Objective: To investigate the effect of Minimally invasive nail for the treatment of thoracolumbar fractures without nerve injury. Methods: A total of 49 patients with thoracolumbar fractures without nerve damage treated in our hospital from June 2016 to June 2018 were selected as observation group, and 49 patients with thoracolumbar fractures without nerve injury treated from May 2014 to May 2016 were selected. The patient served as a control group. In the control group, the traditional posterior approach was used to treat the injured bone graft. The observation group was treated with minimally invasive nailing from the paravertebral space. The intraoperative blood loss, operation time, postoperative drainage and other surgical conditions were compared. The height of the vertebral body leading edge, the kyphosis Cobb angle, the Visual Analogue Scale (VAS), and the preoperative and postoperative time, Oswestry Dysfunction Index (ODI) questionnaire, serum phosphocreatine kinase levels, and paraspinal muscle EMG detection abnormal fluctuations were compared. Results: The amount of intraoperative blood loss, postoperative drainage, and postoperative bed rest in the observation group were less than those in the control group (P<0.05). There was no significant difference in the height of the anterior border and the kyphosis Cobb angle between the two groups in the 3rd and 6th months (P>0.05). One, 3, and 6 months after surgery The VAS and ODI scores of the observation group were lower than those of the control group (P<0.05). Serum phosphocreatine levels were lower in the observation group than in the control group at 1, 3, 5, and 7 days after surgery (P<0.05). The abnormal fluctuation rate of paravertebral EMG in the observation group at 1, 3, and 6 months after operation was lower than that of the control group (P<0.05). Conclusion: Minimally invasive nail for the treatment of thoracolumbar fractures without nerve injury can reduce intraoperative blood loss and postoperative drainage, accelerate postoperative rehabilitation, and reduce the damage to paravertebral muscles and paravertebral soft tissue. The multi-fracture muscle innervation function is preserved, and the degree of postoperative lumbar pain and dysfunction is reduced.