Objective:To explore the effects of pedicle screw placement through posterior median approach,Wiltse intermuscular space approach and percutaneous approach on perioperative indexes and prognosis in patients with single-segment thoracolumbar frac-ture.Methods:According to different surgical methods,90 patients with single-segment thoracolumbar fracture in the hospital were di-vided into posterior median approach group(n=34),Wiltse approach group(n=28)and percutaneous approach group(n=28).The perioperative indexes,bone metabolism indexes,serum muscle enzymes,thoracolumbar recovery and postoperative complications were compared among the three groups.Results:In Wiltse approach group,percutaneous approach group and posterior median approach group,operation time,length of hospital stay and incision length were gradually increased(P＜0.05).At 48 h after surgery,levels of osteocalcin(OC),osteoprotegerin(OPG)and procollagen type Ⅰ N-terminal propeptid(PINP)were gradually decreased in Wiltse ap-proach group,percutaneous approach group and posterior median approach group(P＜0.05).The levels of serum creatine kinase in Wiltse approach group and percutaneous approach group was lower than that in posterior median approach group(P＜0.05).At 3 months and 1 year after surgery,Wiltse approach group had the best recovery effect on thoracolumbar spine(P＜0.05).There was no significant difference in the total incidence of postoperative complications among the three groups(P＞0.05).Conclusion:Among the three methods,curative effect of Wiltse intermuscular space approach is better in single-segment thoracolumbar fracture,with low inci-dence of complications.