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¹Koç Üniversitesi, Tıp Fakültesi, Nöroşirürji Anabilim Dalı, İstanbul, Türkiye Anterior and non-anterior approaches are performed in the surgical treatment of degenerative thoracic spinal diseases. Anterior approaches allow access to the pathology without touching the spinal cord, but the opening of the thorax causes an increase in mortality and morbidity. Non-anterior approaches are the first choice in thoracic spine pathologies. Anterior approaches include thoracotomy, mini-thoracotomy and thoracoscopy. The complication rate of thoracotomy is higher than mini-thoracotomy and thoracoscopy. Thoracoscopic surgery is preferred as it is minimally invasive, but the training period is longer. Anterior approaches may be preferred, especially in the surgical treatment of giant, calcified thoracic disc herniations. The experience of the surgeon and location of the pathology on the spine determines which surgical approach will be applied. Anahtar Kelimeler : Mini-thoracotomy, Thoracoscopy, Thoracotomy