Objective To look at how patients with spinal fractures' spinal function, psychological stress, anxiety, and depression are affected by minimally invasive percutaneous pedicle screw internal fixation and stress theory-based psychotherapy. Methods Sixty spinal fracture patients admitted at our facility between June 2020 and June 2022 will serve as the study subjects. Both the control and observation groups, totalling sixty people, were randomly divided into two groups of thirty using a random number table. As opposed to the control group, who underwent open surgery and received the gold standard of treatment, the observation group underwent percutaneous minimally invasive pedicle screw internal fixation and stress theory-based psychological counselling. The operation time, intraoperative bleeding, incision length and hospital stay; ODI score; Noradrenaline (NE); systolic blood pressure (SBP); heart rate (HR); The Self-Rating Anxiety Scale (SAS) and the Self-Rating Depression Scale (SDS) were used to evaluate and compare the two groups (SDS). Results Time spent in surgery, amount of blood lost during the procedure, length of the incision, and total time patients spent in the hospital all decreased considerably (P<0.05) in the observation group compared to the control group. Scores on the ODI after surgery were lower in both groups compared to those before surgery, with the ODI in the observation group being lower than that in the control group by a statistically significant margin (P<0.05); In the postoperative period, NE, SBP, and HR all increased dramatically from preoperative readings in both groups; however, all three readings were significantly lower in the observation group than in the control group (P<0.05); After surgery, SAS and SDS scores for both groups dropped significantly from pre-op levels, with a more dramatic drop for the observation group compared to the control group.Conclusion Patients with spinal fractures can benefit from the combination of minimally invasive percutaneous pedicle screw fixation and stress theory-based psychological therapy because it has a high clinical reference value and improves operation-related indices and spinal function while reducing psychological stress, anxiety, and depressive symptoms.