Up to now, all domestic and international clinical studies have confirmed that all conservative treatment measures are ineffective for thoracic spinal stenosis and that surgery is the only effective treatment for thoracic spinal stenosis. The word “all” means that various non-surgical treatments, including acupuncture, massage, physical therapy, Chinese medicine, and Western medicine, have no therapeutic effect on thoracic spinal stenosis, and too rough massage may even lead to aggravation of symptoms. So patients diagnosed with thoracic spinal stenosis do not have to run around, do not have to “seek medical help”, and do not have to hope for “prescriptions to cure the disease”, at least for now! So, why not operate as soon as it is discovered? Once the symptoms of thoracic spinal stenosis appear, most patients develop in the direction of progressive aggravation until paraplegia, but at the same time there are a few patients with severe thoracic spinal stenosis, but their clinical symptoms are very 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 severity confirmed by observation can be continuously observed and kept on alert, and once the symptoms are found to have worsened, they should seek medical attention promptly. If the observation continues, will the effect of the surgery be affected in the future? Indeed it may have a negative impact! Numerous 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, i.e., the earlier the surgery is done, the better the postoperative recovery. If we are too conservative and adopt 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 satisfactory results in the future even if the operation is successfully completed. Therefore, there is a time limit for such observation, and unless the symptoms continue without progress, the decision to undergo surgery should be made as soon as possible. Knowing the above facts, 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 monitored, and if they are found to be progressively worse, surgery should be performed as soon as possible.