Eighty-one patients with thoracolumbar vertebral fractures undergoing elective posterior pedicle screw fixation were randomized to receive transcutaneous electrical acustimulation (TEA) at ST36 (n=43) or sham-TEA at nonacupoints (n=38). The primary outcomes of interest were time to first flatus and time to first defecation. Secondary outcomes included Bristol stool score, number of spontaneous bowel movements (SBMs), abdominal bloating, defecation-associated symptoms, wound pain, ambulation time, autonomic function, and serum levels of interleukin-6 (IL-6) and norepinephrine (NE). Outcomes were assessed from preoperative day through postoperative day 4. Overall, the results of the study revealed that TEA significantly shortened the time to first flatus and defecation, improved stool quality and bowel frequency, reduced postoperative pain, enhanced vagal tone, and decreased sympathetic activity and IL-6 levels. These findings suggest that needleless TEA can accelerate postoperative recovery via autonomic and anti-inflammatory mechanisms.