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BACKGROUND: Percutaneous pedicle screw internal fixation is a common minimally invasive operation for clinical treatment of vertebral fractures. The key steps of this operation are puncture positioning and accurate screw placement, which are of great importance for postoperative recovery of patients. OBJECTIVE: To design a coplanar screw placement guide for minimally invasive percutaneous pedicle screw internal fixation, and to observe its clinical value in the treatment of thoracolumbar fractures. METHODS: Totally 60 patients with thoracolumbar fracture treated by minimally invasive percutaneous pedicle screw internal fixation were randomly divided into two groups, with 30 cases in each group. The control group was treated with traditional screw placement technique, and the study group was treated with coplanar screw placement guide assisted screw placement. The screw placement and operation, recent orthopedical and reduction effects, long-term functional recovery and quality of life were compared between the two groups.RESULTS AND CONCLUSION: (1) There were no significant differences in postoperative drainage volume, intraoperative blood loss, hospital stay, fracture healing time, or correction rate between the two groups (P > 0.05). The study group got shorter operation time, fewer intraoperative fluoroscopy times, and higher coplanar rate compared with the control group (all P < 0.05). (2) Visual analogue scale scores in both groups were lower than those before surgery, and the pain scores in the study group at 1, 3 and 6 months after surgery were lower than those in the control group (P < 0.05). (3) At the last follow-up, the anterior edge height ratio, Cobb angle and ODI score of the study group were higher than those of the control group (P < 0.05), while the loss rate of the study group was lower than that of the control group (P < 0.05). (4) It is concluded that the self-made coplanar screw placement guide used in minimally invasive percutaneous pedicle screw technique in the treatment of thoracolumbar fracture has advantages in shortening the operation time, improving the accuracy of screw implantation, reducing radiation leakage and relieving pain, which is benefit for improving long-term quality of life. [ABSTRACT FROM AUTHOR]