Intravertebral tumors are common and frequent diseases in neurosurgery. Primary intravertebral tumors are tumors that originate in the spinal cord, spinal membrane, nerve roots and various surrounding soft tissues in the spinal canal, and are more common in the central nervous system. With the common application of CT and MRI in clinical practice, intravertebral canal tumors can be diagnosed at an early stage. Main clinical manifestations: 1. Radicular pain Radicular pain is a prominent symptom in the early stage, with early appearance and often starting from one side as its typical characteristics. Because intraspinal tumor mostly occurs in the dorsal side of the spinal cord, early stimulation of the dorsal root of the spinal nerve causes radiological pain along the distribution area of the nerve root, often with low back pain, neck and shoulder pain as the first symptom, and gradually appearing signs of spinal cord compression. If there is no root pain, the abnormal sensory symptoms appear later; a few patients may have no obvious root pain but only mild sensory impairment. If the intravertebral tumor is located in the ventral part of the spinal cord, there may be no radicular pain but symptoms of motor nerve root irritation, such as twitching (myocardial jump) of the compressed segment and the innervated muscles with muscle bundle tremors, dyskinesia or weakness. Later in the course of the disease, transverse damage to the spinal cord occurs, manifesting as spastic paralysis of the limbs below the level of the lesion, sensory disorders, autonomic disorders and nutritional disorders, and disorders of the bladder and rectal sphincter. The pain is mostly nocturnal resting pain, and the patient wakes up from sleep (dream) at 1:00 to 2:00 a.m. and is forced to sit up or get out of bed to relieve the pain. The length of the spinal canal changes from full extension to full flexion by about 7 cm, and the longitudinal axis of the spine is stretched in the recumbent position, which makes it easy for the tumor to compress and stimulate the spinal canal. The pain of patients with lumbar disc herniation is reduced after lying down, and sudden pain rarely occurs at night. 3.Volatility and intermittency Primary intravertebral tumor has a long course and pain is often volatile and intermittent, which is also one of the reasons for misdiagnosis. During the diagnosis and treatment, the early symptoms are atypical and fluctuating due to the change of spinal canal internal diameter, spinal cord edema, change of blood circulation and neurological function compensation. 4.Intravertebral canal tumor wedge pressure refers to the sudden increase of pressure difference between cerebrospinal fluid above and below the tumor in the spinal canal or the change of position of the tumor in the spinal canal due to the change of length of the spinal canal, the tumor appears to be shifted, just like a wooden wedge jam, which aggravates the compression of neural tissue and causes pain or even paraplegia, which is called wedge pressure of intravertebral canal tumor. Such symptoms are regular, such as lumbar puncture pain, contrast pain, traction pain or traction palsy, sleep pain, all belong to intravertebral tumor wedge compression, which are more common in clinical practice and have practical significance for clinical diagnosis. 5.Sensory disorder The first symptom is numbness of the limb, weakness or instability of walking, followed by numbness which often rises quickly or extends to the opposite limb, mainly due to the involvement of tactile fibers as well as proprioceptive fibers, which is easily detected by patients at an early stage, but clinically it is easily misdiagnosed as neuritis or spinal cord vascular lesion. 6.Paraplegia or sphincter dysfunction The development of intravertebral tumor is progressively aggravated with sensory, motor and sphincter dysfunction. Generally, the course of the disease is long, about 1 to 3 years, and cauda equina tumor can be more than 10 years. The site of early radicular pain and the plane of sensory impairment can often be used as the basis for segmental localization, and the course of the disease is fluctuating, the pain can be temporarily relieved and then worsened. However, some tumors such as hemangiomas can develop incomplete to total paralysis, also known as spinal cord stroke, hours to days after the onset of radicular symptoms. Treatment The only effective treatment for intravertebral tumors is surgical resection. Early surgery with minimal further damage to the spinal cord during surgery is the key to a good outcome. The goals of surgery are to completely remove the tumor, improve neurological function, stop the deterioration of neurological function, and improve motor and sensory function. Scholars at home and abroad believe that early and clear diagnosis, early surgical resection and timely release of spinal cord compression are the keys to improve the cure rate. At the same time, the effect of surgery also depends on the preoperative neurological function of the patient. According to the data, the lighter the preoperative symptoms of intravertebral tumor, the better the effect of surgery, and it can even reach the normal state. The effect of surgery is related to the time, extent and degree of nerve tissue compression, the nature and location of the tumor and the degree of resection. Before the period of complete spinal cord compression, the surgical result is good, while the longer the period of complete spinal cord compression, the worse the surgical result.