The incidence of patients with thoracic disc herniation is low, but the surgical risk is high because of the narrow thoracic spinal canal and because the spinal canal contents are the spinal cord. The indications for surgery are: those who have spinal cord damage as the main manifestation, or those who have intractable pain in the thoracic back or intercostal neuralgia, and for whom conservative treatment is ineffective. The surgical procedures include three types: 1) transthoracic disc removal, which is suitable for disc herniation of thoracic 4 to 12; 2) disc removal via sternal and medial clavicle resection route, which is suitable for disc herniation of thoracic 1 to 4; 3) disc removal via transverse costal joint resection route, which is suitable for disc herniation of thoracic 1 to 12. For thoracic disc herniation that is huge and calcified and causes stenosis of the thoracic spinal canal, the transcostal transverse synovectomy approach is undoubtedly the most thorough and safe, and it is suitable for all thoracic discs, and this procedure does not require incision of the thoracic cavity, which is relatively less traumatic and conducive to postoperative recovery. This procedure is also our usual treatment for thoracic spinal tuberculosis. The following is a Portuguese male patient, 43 years old. The patient presented with right intercostal neuralgia 1.5 years ago and was diagnosed in Portugal with a massive disc herniation in the thoracic spine at 6 and 7. Probably because it was a risky procedure, the Portuguese surgeon performed only an intercostal nerve decompression procedure without thoracic disc management. After surgery, the surgeon told the patient that he should not play strenuous sports such as soccer in the future. The patient happened to be very fond of sports, especially playing soccer, and had represented the Macau team in several competitions. The patient developed pain in the thoracic back 1.5 years after surgery, especially when he lowered his head, and CT and MRI showed a huge herniated disc in thoracic spine 6 and 7 with calcification and thoracic spinal stenosis. The patient lived in Guangzhou and was advised to have surgery, but because it was a re-operation and a huge thoracic disc herniation, the surgery was difficult and risky and he was advised to go to Beijing for treatment. On examination at admission: a longitudinal surgical scar in the middle of the thoracic back, 12 cm long. Flexion of the neck caused back pain and positive pathological signs in both lower limbs. MRI and CT showed massive disc herniation in thoracic spine 6 and 7 with calcification and severe stenosis of the thoracic spinal canal. We performed a transcostal transverse synovectomy route for disc removal, after which the patient’s back pain disappeared and he recovered well. He was able to play sports normally after 6 months and could continue to play soccer 1 year after surgery, so the patient was very satisfied. For a huge thoracic disc herniation with calcification, our experience is that it is not necessary to completely remove the calcified disc because of its adhesion to the dura, and the cul-de-sac collapse method can be used to remove most of it, leaving a little of the calcified disc tissue adhering to the dura, so that it collapses and floats and no longer compresses the spinal cord. Forced removal of the remaining intervertebral disc tissue is likely to cause spinal cord injury or dural tearing, resulting in cerebrospinal fluid leakage. Preoperative sagittal CT shows huge herniated disc of thoracic 6 and 7. Postoperative X-ray showed that the posterior adjacent endplates and vertebral bodies of the thoracic 6 and 7 intervertebral spaces were resected. Postoperative sagittal CT showed that the thoracic 6 and 7 intervertebral plates were resected, the posterior adjacent endplates and vertebral bodies of the intervertebral spaces were resected, most of the herniated discs were removed, the dorsal residual parts were floated, and the spinal canal was sufficiently decompressed Postoperative axial CT showed that the vertebral plates were resected, the posterior part of the vertebral bodies were resected, and the herniated discs were partially removed. The dorsal portion of the herniated disc was removed, the dorsal portion was floated, the rib implant was placed, and the decompression of the spinal canal was adequate.