Unlike the cervical and lumbar spine, the thoracic spine has a much more restricted range of motion. This is due primarily to the rib cage and torso. There are other anatomical considerations that make the thoracic spine unique and actually more difficult to deal with in regards to surgical approaches. Fortunately, thoracic disc herniations are much less common than cervical and lumbar discs. The spinal canal is much narrower in the thoracic spine, leaving relatively little room to work in. The spinal cord nearly fills the entire canal, so there's little reserve when it comes to disc herniations, fractures, and other sources of compression. Posterior approaches to the disc space are limited because of these considerations. Anterior approaches require large exposures that go through the chest or upper abdomen.

Like other disc herniations, symptoms usually arise when the nerve is compressed or "pinched." In this part of the spine, that usually means pain that "shoots" or radiates across the chest or abdominal region. There is often accompanying numbness or a "tingling" sensation. There may or may not be back pain, which is usually higher up than the common low back pain.

Larger disc herniations can cause compression of the spinal cord. This can lead to difficulty walking, incontinence, and decreased sensation below the level of the spinal cord affected. The legs may become stiff or spastic and difficult to control. Similar symptoms can occur when the thoracic spinal cord is compressed due to stenosis (narrow canal), fracture, tumor, cyst, or any other mass or lesion.