The authors describe six cases of thoracic disc disease successfully treated by anterior spinal cord decompression via the transpleural or retroperitoneal approach. The patients included two with ossification of the posterior longitudinal ligament, one with a soft disc, and three with spondylosis (two of whom had ossification of the yellow ligament at the level of the spondylosis). The lesions were situated at the Th7 to L2 levels. In all cases the protruding disc, spur, or ossified ligament was completely removed. In five cases bone grafting was performed, and in three, anterior internal fixation was accomplished with a Kaneda device. All six patients' neurological deficits improved. Thus, when neurological deficit results from anterior pressure on the dural tube at the thoracic level, anterior decompression is an effective therapeutic procedure.
