Objective To analyze the influence of Wiltse approach and conventional transmuscular approach on the multifidus muscle by imageology, histology and electrophysiology assessment following short-segment pedicle fixation on thoracolumbar fractures. Methods 76 patients with thoracolumbar fractures without neurological deficits who had undergone short-segment pedicle fixation between June 2010 and August 2012. Wiltse approach 36 cases, conventional transmuscular approach 40 cases. The perioperative parameters, Visual Analogue Scale scores (VAS), and radiologic parameters, esp the imageology, histology and electrophysiology changes of multifidus muscle were compared. Results 20 cases were fellowed up over 1 year in the Wiltse approach group (20/36, 56%). 25 cases were fellowed up over 1 year in the conventional transmuscular approach group (25/40, 62.5%). No significant differences were found in terms of gender, age, fracture type, injured segment and follow-up period. Till the last follow-up, all patients with vertebral fractures were healed. No loosening or breaking of internal fixation was observed. Compared to the conventional transmuscular approach, the Wiltse approach was significantly advantageous in terms of operation time, the amount of bleeding, hospital stays and VAS scores after the surgery but the length of incision, besides, the Wiltse approach group had less incidence of multifidus atrophy and less fatty infiltration, and in conventional transmuscular approach group electromyography demonstrated that the multifidus muscles median frequency values and average amplitude value were significantly lower than Wiltse approach group. Conclusion The Wiltse approach for thoracolumbar fractures, retaining the posterior ligament complex, is an effective and minimally invasive treatment, with less trauma, less bleeding, less operation time, the advantages of reliable clinical results. Especially less incidence of multifidus atrophy and less fatty infiltration. Key words: Spinal fractures; Electromyography; Histology, comparative