Objective To explore the efficacy and safety of posterolateral approach decompression combined with interbody fusion and internal fixation for the treatment of thoracic spinal stenosis. Methods A total of 32 cases with thoracic spinal stenosis underwent posterolateral approach decompression combined with interbody fusion and internal fixation. Spinal cord function was evaluated according to Frankel Classification before operation, at 1 year and 2 years after operation. And the efficacy was assessed using Otani grade at 2 years after operation. The operative complications were recorded. Results The operations were successfully completed in all of the cases. The average operative duration was (3.5±0.6) h (range, 2.3 to 5.2 h). The average intraoperative blood loss was (950±100) mL (range, 450 to 2 000 mL). At 1 year after operation, 17 cases, 12 cases and 3 cases were assessed as grade C, D and E according to Frankel Classification respectively. At 2 years after operation, 8 cases, 17 cases and 7 cases were assessed as grade C, D and E respectively. There were statistical differences in the grades at 1 year and at 2 years after operation compared with the grade before operation (P＜0.05). And a statistical difference in the Frankel grade was observed between 1 year and 2 year after operation (P＜0.05). The evaluation of clinical efficacy at 2 years after operation showed that 15 cases (46.88%) were excellent, 12 cases (37.50%) were good and 5 cases were common (15.62%) . The excellent and good rate was 84.38%. Cerebrospinal fluid leakage occurred in one case during operation, and the spinal cord dysfunction of one case was aggravated postoperatively, but the situation was under control effectively after the targeted management. Conclusions Posterolateral approach decompression combined with interbody fusion and internal fixation is effective and safe for patients with thoracic spinal stenosis.

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