After a CT or MRI reveals thoracic spinal stenosis, doctors often instruct patients to avoid traumatic injuries such as falls and stumbles, and may even warn them that a less serious trauma could lead to paralysis! This sounds quite scary, so is the doctor scaring people or not? No! There is a sound theoretical and factual basis for this reference. Theoretically speaking, the thoracic spinal canal is a tube that houses the thoracic spinal cord. Normally, there is a gap of one or two millimeters around the spinal cord, which we call “reserve space”, meaning that the spinal cord can have a certain amount of cushion in the spinal canal in case of trauma, which can avoid the serious situation of spinal cord injury. When the thoracic spinal canal is narrowed, the reserve space around the spinal cord becomes smaller or even completely gone, and the spinal cord loses its cushion when it is injured again, making it easy to be squeezed or struck and paralyzed. In our clinical work, we have seen some patients who were originally normal, but because of a minor trauma such as a fall on a slippery road in snowy weather, a fall down the stairs, or a slip from a ladder, the lower extremities became obviously paralyzed, and the pathological basis of thoracic spinal stenosis was confirmed after examination. I have also seen patients with diagnosed thoracic spinal stenosis who were not too symptomatic and then fell and could no longer stand up. Of course, these cases are in general a minority, and most patients could have been prevented from suffering such a significant loss with adequate attention. The purpose of talking about this topic is really not to increase the tension of our friends with thoracic spinal stenosis, but rather to make them aware of the condition and to pay attention to it and take safety precautions to ensure that accidents are avoided. In order to avoid trauma, some patients wear a lumbar brace to protect the spine, but this practice is basically ineffective, but will limit the range of motion of the spine, and long-term wear will also cause disuse atrophy of the paravertebral muscles, which ultimately outweighs the losses. The correct approach is to raise safety awareness in daily life, pay attention to the implementation of trauma prevention details, such as: rain and snow days to go out less, usually wear non-slip shoes, walking speed control and pay attention to the foot, when the gait is unstable with a cane or walker, bathroom floor with non-slip mats and so on.