Spinal metastases generally have primary tumors, and the primary sites are mostly in the lungs, prostate, breast and other parenchymal organs. The key points to distinguish them from spinal metastases are as follows: 1. The nature of pain is different: most spinal tuberculosis pain can be relieved to some extent by rest, while pain caused by spinal metastases is difficult to be relieved by rest; 2. There are differences in imaging between spinal tuberculosis and spinal metastases: most spinal tuberculosis has worm-like bone destruction, sand-like dead bone and abscess formation, while spinal metastases form soft tissue masses, which are different in imaging; 3. Most of the spinal metastases are caused by symptoms of tumor at the primary site and metastasis to the spine, such as back pain and localized pain in the spine.