Background: Patients who experience symptoms from herniated thoracic discs may need to undergo surgery due to severe radiculopathy or myelopathy that significantly impairs their functionality. Historically, laminectomy has been the preferred surgical intervention for managing thoracic herniations. However, the technique has been associated with a significant incidence of morbidity. As a result, many approaches have been evolved to remove the herniated disc without affecting the spinal cord's structure.

Objective: The primary objective of this study is to assess the effectiveness of the costotransversectomy approach in the management of thoracic disc herniations.

Methods: This is a retrospective study reviewing 12 patients who were diagnosed with herniated thoracic disc and subsequently underwent surgical intervention using a costotransversectomy approach in conjunction with laminectomy. The surgeries were performed between the years 2017 and 2021 at the neurosurgery department of Minia University.

Results: eighty percent of the herniated discs were in the posterolateral region, while the remaining twenty percent were situated in the lateral region. Calcifications were observed in 80% of the patients. There were no significant intraoperative problems experienced. The surgical outcomes were deemed excellent in 66.7% of cases, good in 16.7% of cases, fair in 8.3% of cases, and poor in 8.3% of cases. Out of the individuals diagnosed with myelopathy, a total of ten individuals were able to restore the ability to walk, while seven individuals were able to regain normal bladder function.

Conclusion: costotransversectomy technique demonstrates its greatest suitability for addressing lateral or posterolateral calcified or soft discs, yielding satisfactory outcomes.