Because the natural course of thoracic spinal stenosis is one of progressive worsening of symptoms and a poor prognosis, early surgical treatment is more effective. However, not all patients with thoracic spinal stenosis require immediate surgical treatment. So here are two questions: 1. Why not operate as soon as it is discovered? Once patients with thoracic spinal stenosis become symptomatic, most of them develop in the direction of progressive worsening until paraplegia, but at the same time there do exist a small number of patients with severe thoracic spinal stenosis, but whose clinical symptoms are mild and stable and can be maintained for several years without progression. If it is confirmed by observation that the symptoms of the lower extremities gradually worsen and the walking becomes more and more unstable, then the result of waiting for a long time is definitely paralysis, in which case the only hope for relief is to undergo surgical treatment. Patients with mild symptoms and no progress in the severity of the disease confirmed by observation can continue to observe and maintain a vigilant state, and once the symptoms are found to have worsened, they should seek medical attention in a timely manner. 2.If the observation continues, will the effect of the surgery be affected later? There may indeed be adverse effects! A large number of studies have confirmed that the duration of preoperative disease (the length of time from the onset of symptoms to the time of surgery) is inversely proportional to the outcome of surgery, that is, the earlier the surgery is done, the better the postoperative recovery. If we are too conservative and take the practice of continuous observation and do not operate until we are close to paralysis, we actually miss the best time to operate, and we may not be able to obtain more satisfactory results in the future even if the operation is successfully completed. Therefore, this observation is for a limited period of time, and unless the symptoms continue without progress, the decision to undergo surgery should be made as soon as possible. The reasonable choice for patients diagnosed with thoracic spinal stenosis is to undergo surgery as soon as possible if the symptoms of weakness and unsteadiness in the lower extremities have developed to a more pronounced degree; if the symptoms are mild (e.g., only a slight numbness in the lower extremities and normal walking), the symptoms can be closely observed, and surgery should be performed as soon as possible if the symptoms are found to be progressively worse.