Although most of the intravertebral tumors are benign, if they are allowed to develop, they will still cause some chaos in the narrow space like spinal cord and vertebral canal, for example, the symptoms of pain are getting more and more serious, the numbness of limbs and movement disorders are getting heavier and heavier, and the bowel and stool are slowly getting out of control, which seriously affects the quality of life. Therefore, if intravertebral tumor is found, it should be surgically removed in time. Generally speaking, most benign tumors, such as nerve sheath tumors, spinal meningiomas, and some ventricular meningiomas, can be cured after surgical resection, while for malignant tumors, such as spinal cord glioma, astrocytoma, and metastatic intravertebral tumors, some lymphomas, etc., subsequent radiotherapy or other adjuvant treatments are often required after surgical resection to prevent the tumors from recurring. Moreover, the surgical approach varies for different sites of intradural tumors. Most tumors often require surgical operation under a microscope because of the need to clear them cleanly, which is different from the so-called minimally invasive concept. The concept of minimally invasive often refers to small incisions, whereas microscopic surgery is performed to clear as many tumor cells as possible and to protect nerves and blood vessels, and some may have small incisions while others may require larger incisions. If the tumor is inside the spinal cord, it is more difficult to operate; if the tumor is outside the spinal cord or even outside the dural spinal canal, it is less difficult to operate. If the tumor grows in the cervical segment, the surgery is more risky, and if the tumor grows in the lumbosacral segment, the surgery is a little less risky. In order to ensure a smooth operation, in addition to the microscopic technique, neurophysiological monitoring will be used to prevent damage to the nerves. Therefore, this type of surgery is relatively safe. As for the possible paralysis or incontinence after surgery, most of them are related to the location and nature of tumor growth. Generally speaking, after the surgery to remove the tumor, the patient’s symptoms will be gradually relieved. Generally, the postoperative review of MRI can determine whether the tumor is removed cleanly. However, it is not necessary to pursue total resection without paying attention to protecting nerves and blood vessels; otherwise patients will suffer from neurological impairment after surgery. Once intravertebral tumor is diagnosed, it is usually treated by surgery first. However, some patients are afraid of going to the operation table, so they think that using gamma knife to shine a light can kill the tumor cells as well. In fact, due to the small space of the spinal canal, radiation can easily injure the nearby spinal cord and nerve roots, generally there are residual tumor lesions after surgery, or recurring tumors, before the appropriate consideration of gamma knife.