1. For asymptomatic metastatic spinal tumors, there is a growing tendency for early surgery, and “asymptomatic” is no longer a contraindication for surgery. For those who suspect metastatic spinal tumors but the diagnosis is not clear, surgery can be used to obtain pathological diagnosis. Of course, the above principles should be followed during surgery. In asymptomatic patients with a clear diagnosis, early surgery has been shown to be more effective than waiting for symptoms to develop. The aim of surgery for these patients is different, i.e., to prolong survival and to strive for a radical cure. Therefore, case selection should focus on those in better general condition. For those who are in poor physical condition, if they can be improved by internal medicine or radiotherapy, they can also undergo surgery. Asymptomatic patients must be actively treated for primary foci after surgery, and effective comprehensive treatment programs should be formulated according to the type of pathology, in order to strive for radical treatment. Yang Cao, orthopedic department of Wuhan Union Hospital 2, some scholars believe that paraplegic patients have a certain recovery rate after surgery. For paraplegic patients, some people believe that it is impossible for surgery to restore nerve function, and even list paraplegia as a contraindication to surgery. In recent years, with the improvement of surgical methods, 22% of paraplegic patients can recover their mobility after surgery. As a result of the development of treatments, patients with metastatic spinal tumors can expect a longer survival period, and surgery can at least resolve the intractable pain in paraplegic patients. Recently, the research on nerve regeneration and spinal cord repair has achieved promising results, which increases the possibility of paraplegic patients to regain their mobility after surgery.3. For symptomatic metastatic spinal tumors, surgical treatment was only used for those who had no effect of internal medicine and radiotherapy in the past, which was related to the concept of treatment and the purpose of treatment at that time. Nowadays, in addition to relieving symptoms, the treatment aim of metastatic spinal tumor is to prolong the survival period and strive for radical treatment. The treatment modality has also entered the era of comprehensive treatment, in which surgery and other treatment modalities are not conflicting with each other, but complementary to each other to improve the efficacy of treatment.