Objective To evaluate the feasibility and efficacy of lamina osteotomy and replantation with miniplate fixation in the treatment of thoracic myelopathy due to ossification of the ligamentum flavum(OLF). Methods Between January 2008 to March 2010, a total of 18 patients (8 men and 10 women; average age 56.3; mean disease course 24.8 months) who received the procedure of lamina osteotomy and replantation with miniplate fixation due to contiguous multilevel OLF were included in this study. The clinical efficacy and radiologic parameters were investigated pre- and postoperatively, especially complications occurred in the procedure. Results After a average 35- month follow-up, the mean score according to the Japanese Orthopedic Association (JOA) scale improved from 4.7 ± 1.4 preoperatively to 7.9 ± 1.3 at 3 months after the operation and 8.8 ± 1.3 at the final follow-up (P<0.01), with a mean recovery rate of 67.8% ± 13.1%. There was no significantly kyphotic deformity occurred after the surgery, and the Cobb angle just had a mean of 1.9°±1.0° increase at the final follow up. No patient required additional surgery due to spinal canal re-obstruction and progressive spinal instability. Cerebrospinal fluid leakage occurred in 4 patients, and healed well after being repaired. A lung infection and a deep vein thrombosis occurred in 1 patient respectively, and they were safely discharged after a regular treatment. Conclusions Lamina osteotomy and replantation with miniplate fixation is an effective therapeutic option for thoracic myelopathy due to contiguous multilevel OLF compression, it not only provide an adequate decompression and a stabilized sagittal alignment, but also avoid the scar tissue invade to the spinal canal.