A herniated disc can cause intercostal scapular girdle pain by compressing the spinal nerve roots at the root canal nerve outlet. Intercostal scapular pain is a clinical manifestation of thoracic disc herniation. How can intercostal scapular pain be effectively prevented? Non-surgical treatment of thoracic disc herniation: mainly used for light cases, especially for those who are old and frail, whose nucleus pulposus has calcified or ossified without the possibility of re-displacement development, and whose main measures include the following: (a) Treatment 1. Rest: depending on the condition, choose absolute bed rest, general rest or limit the amount of activity. The former is mainly used for patients in the acute stage or those whose condition has suddenly increased. 2, thoracic braking: due to the role of the thoracic contour, the thoracic spine itself is very little mobility, but for safety reasons, the mobile cases can be supplemented with a thoracic back brace to be fixed, which will have positive significance for the reversal of the disease or to prevent deterioration. 3, symptomatic treatment: including oral sedatives, external analgesic and anti-inflammatory creams, physiotherapy, blood-activating drugs and other effective therapeutic measures, etc., can be used as appropriate. Surgical treatment of thoracic disc herniation: Because of the serious consequences of this disease, once diagnosed, especially for active cases around middle age, active surgical treatment should be considered to prevent further posterior protrusion of the nucleus pulposus with the risk of “time bomb” and cause transection damage to the thoracic marrow. Once this happens, it will be too late to regret. Of course, for those who do not have indications for surgery, they should not be operated arbitrarily to prevent misinjury and aggravation of the disease. (Even if the spinal cord is severely compressed, as long as a little sensation is retained, or even just sensation around the anus, surgery can be performed. The authors have had several cases in which the patient returned to normal life under such conditions. ②Progressive aggravation of the disease: emergency surgery should be performed. Because the sagittal diameter of the thoracic spinal canal is significantly smaller than that of the lumbar and cervical spine, there is little room for the substantial thoracic spinal cord to regress when the nucleus pulposus protrudes posteriorly. Once this soft spinal cord parenchyma is damaged by the extrusion of the nucleus pulposus which is harder than itself, transverse damage can be formed immediately, so that the timing of surgery is lost. (iii) Mild cases: The choice of whether to perform surgery is discretionary. Non-surgical treatment can be used for mild cases, but for those who are young, have a high activity level, are in the field, or are in the nature of sports and cultural work, the patient should be informed of the situation so that he or she can understand the possibility of accidents. If the patient is unable to avoid increased activity and requests surgery, surgery should be performed, including simple fusion of vertebral segments or difficult nucleus pulposus removal + internal fixation. (2) Surgical options: The main types of surgical procedures used for thoracic discectomy and fusion are as follows: ① Anterior surgery: that is, the thoracic or combined thoracoabdominal incision is used to reach the front of the thoracic vertebral segment, and the nucleus pulposus of the posterior protrusion is removed and internal fixation (fusion) is performed at the same time. This procedure is safe, effective, and allows for ideal decompression of the spinal canal while also obtaining a good internal fixation that restores the height of the vertebral segment. Posterior surgery: This traditional procedure has been used for many years, and most orthopedic or neurosurgeons are familiar with this surgical approach, and it is easy to perform. However, it is quite difficult to remove the nucleus pulposus anterior to the thoracic spinal canal, especially in central cases, and it is often difficult to bypass the delicate thoracic medulla to achieve satisfactory removal of the nucleus pulposus or ossified material, and may even cause misinjury to the thoracic medulla during surgery. Moreover, intraoperative bleeding is more frequent, mainly due to more bleeding at the root vein plexus on both sides and the difficulty of hemostasis. Therefore, most scholars oppose this surgical route. (B) Prognosis The prognosis of this disease varies greatly, and its consequences mainly depend on the following factors. 1. Severity of the disease: those with mild or moderate disease have a better prognosis; however, in patients with severe disease, especially those who have caused complete paralysis, the prognosis is poor. 2, the onset of speed: slow onset, mostly due to simple degeneration, the prognosis is better; on the contrary, if the patient has a rapid onset, it indicates that the vertebral joint is unstable, easy to aggravate the condition due to trauma and other factors, so the prognosis is poor. 3, the sagittal diameter of the spinal canal: where the sagittal diameter of the thoracic spinal canal is narrow, because it has no buffer, easy to accident due to trauma or other factors; and the spinal canal is wide because of its compensatory gap is wide, the prognosis is generally better. 4, appropriate and timely treatment: whether the treatment is timely and effective and the prognosis of this disease is directly related, should be paid attention to. Do not delay treatment and aggravate the patient’s condition due to the lack of understanding of the disease by the treating physician. In addition, the use of thoracoscopy can also be performed thoracic discectomy, and both the efficacy of fusion of vertebral segments.