【Abstract】 Objective To investigate the method and effect of posterior instrumental distraction and reduction, long-segment fixation with wirtse approach and bone graft fusion for complete thoracolumbar fracture and dislocation. Methods Six patients with complete thoracolumbar fracture and dislocation were enrolled from June 2016 to April 2019. All of them were male, with an average age of 33.7 years (28-41 years). The average time from injury to surgery was 9 days (4-12 days). Fracture dislocation classification: AO classification is c-type, Denis classification is three-column injury, Meyerding traumatic spondylolisting V-grade fracture and dislocation. Spinal nerve injury was classified by the American Spinal Injury Association (ASIA): 6 cases were grade A. Fracture and dislocation segments: T11-T12: 2 cases, T12-L1: 2 cases, T12-L 1:1 cases, L1-L2: 1 case. All patients were treated with posterior instrumental distraction, long-segment fixation via Wiltse approach, and bone graft fusion. Results The average operation time was 161 mins, the average intraoperative blood loss was 550 ml, and 6 cases were all treated with anatomical reduction. After an average follow-up of 8 months, there was no significant change in postoperative neurological function in 6 patients. All patients had no internal fixation-related complications such as loosening of the nail rod during the follow-up period. Conclusions Posterior instrumental distraction and reduction, long-segment fixation by wiltse approach, and bone graft fusion for severe thoracolumbar fracture and dislocation have the advantages of less trauma, less bleeding, and satisfactory reduction. It is worthy of clinical promotion.