Tomita spinal tumor types 2 to 5 are indications for total spine resection, which can significantly prolong the survival of patients. However, because of the proximity of spinal tumors to large blood vessels, spinal cord and major organs, total spine resection is difficult and bleeding is high, especially for patients over 70 years of age, the risk of surgery is significantly increased. There are few reports in the previous literature of total spine resection in patients over 70 years of age. Our patient in this case was a male, 70 years old, with isolated lumbar 3 vertebral metastasis from prostate cancer, which was type 5 according to Tomita’s spinal tumor staging, and was an indication for total spine resection. The patient had back pain for 2 months and had difficulty walking for the last month with radiating pain in both lower extremities. Through a detailed preoperative evaluation, we concluded that the patient could tolerate a total lumbar 3 vertebral body resection and performed a total spondylectomy on the patient. The surgical procedure went smoothly, and the patient’s low back pain and lower extremity radiating pain were significantly relieved after surgery, and he was discharged from the hospital as scheduled 1 week after surgery. The following is the patient’s preoperative, intraoperative and postoperative information.