This study was carried-out for study the role of Cpk as a detector for muscle damage degree in both open versus percutaneous thoraco-lumbar spine fixation. this study was a prospective case series study performed in the Neurosurgery, by operating on 60 instances hospitalized to Al-Azhar University Hospitals with the diagnosis of thoracolumbar fractures, degenerative lumber instability, lumber canal stenosis. The trial began in May 2021, and the operated patients had a 12-month follow-up. This study concluded that, the level of CPK is higher in its level in opend group than the percutaneous group, The extent, range, and duration of muscle stripping are all linked with blood creatine phosphokinase activity. Consequently, creatine phosphokinase is a more accurate signal when evaluating muscle damage and judgement on the efficiency of the open or percutaneous operation for preservation of muscle from damage. so, the percutaneous fixation method is preferable and more efficient for preservation of skeletal muscle from damage.