Objective: To investigate the clinical efficacy of minimally invasive percutaneous posterior short-segment pedicle screw fixation with non-bone graft fusion in the treatment of flexion-stretch type(AO classification B) unstable thoracolumbar spine fractures with posterior ligament complex injury. METHODS: A retrospective analysis of 39 flexion-stretch unstable thoracolumbar fractures with posterior ligament complex injury treated in our hospital from January 2015 to October 2018, with an average follow-up time of 14.2 ± 1.1 (13-18) month. Observe the operation time, the amount of bleeding during the operation, the time of wearing the brace and leaving the bed, record the postoperative complications, and compare the height of the anterior edge of the injured vertebrae, the Cobb angle of the sagittal plane, and visual analog scale (VAS), Oswestry disability index (ODI) before and after surgery, at 1 month after operation and at the last follow-up. RESULTS: The average operation time was 85.5 ± 6.1 (75 ～ 100) min; the intraoperative blood loss was 60.3 ± 23.1 (45 ～ 90) ml, and the time of leaving bed after operation was 2.6 ± 0.3 (2 ～ 3) days, except one patient had superficial soft tissue infections without other serious complications. The anterior height of the injured vertebra, Cobb angle, VAS, and ODI scores were significantly improved at 3 days, 1 month, and at the last follow-up (P <0.05), and there was no statistical significance at various time points after surgery. Conclusion: Minimally invasive percutaneous posterior short segment pedicle screw fixation with non-bone graft fusion for flexion-stretch unstable thoracolumbar spine fractures with neurological function intact and posterior ligament complex injury is safe and effective, reduces approach-related trauma, and can effectively maintain the height of the anterior edge of the injured vertebra and the local Cobb angle after the operation.