About 2-13% of patients with differentiated thyroid cancer (papillary and follicular thyroid carcinoma) may develop secondary bone metastases. Of these, about half of the metastases are located in the spine. Pain and impaired neurological function seriously affect the quality of life of these patients or even threaten their survival, and clinical management is not difficult. The clinical manifestations of thyroid cancer bone metastases can appear earlier or later than the primary tumor of the thyroid gland. Experience suggests that the prognosis is usually better for the former (metastatic bone tumors presenting earlier) than for the latter. Patients with metastatic thyroid cancer of the spine often require comprehensive management, and clinical management involves multiple modalities, which are highly representative of all thyroid cancer bone metastases, and it is necessary to make a brief review of each of them for the reference of patients and colleagues. 1.Iodine-131 therapy: This is the first-line treatment for bone metastases of differentiated thyroid cancer. It is applicable to all iodine-intake metastases, and some patients can be cured by iodine-131 treatment, especially those with small tumors that have not yet invaded the bone cortex, or those with complete surgical resection of metastases. 2.Stereotactic body radiation therapy and vertebral body total resection. These two are the second-line treatments for bone metastasis of differentiated thyroid cancer. Among them, stereotactic body radiation therapy is suitable for patients whose lesions are confined to the vertebral body without spinal cord compression, nerve damage and compression fracture; while vertebral body resection is suitable for patients whose lesions have paravertebral invasion, spinal cord compression, nerve damage and compression fracture. The aim of these two treatments is to eradicate thyroid cancer bone metastases. 3. External irradiation therapy, percutaneous vertebroplasty, surgical fixation, surgical decompression, palliative radiotherapy, ablation, selective embolization: these are the third-line treatments for bone metastases of differentiated thyroid cancer, which cannot completely remove the bone metastases by themselves. Percutaneous vertebroplasty and surgical fixation aim to stabilize the vertebral body and are indicated for patients at risk of compression fracture (with or without pain); surgical decompression, palliative radiotherapy, ablation, and selective embolization aim to destroy the tumor (necrosis) and prevent epidural invasion. For patients at risk of epidural invasion. 4. Drug therapy (bisphosphonates, monoclonal antibodies): for all patients with bone metastases from differentiated thyroid cancer, with the aim of inhibiting bone destruction and vertebral fractures. The above-mentioned modern therapeutic techniques regarding thyroid cancer spinal metastases significantly improve the local control rate of the tumor while effectively controlling pain and protecting neurological function, objectively improving the quality of life of patients. It is easy to see that these techniques involve multiple disciplines and treatment modalities such as endocrinology, nuclear medicine, radiotherapy, interventional radiology, medical oncology and neurosurgery. Doctors should make reasonable choices and applications according to the specific conditions of patients.