The spinal cord is located in the vertebral canal and is cylindrical in shape, with a total length of about 42-45 cm. 31 pairs of spinal nerve roots are divided from the top down, including 8 pairs in the cervical segment, 12 pairs in the thoracic segment, 5 pairs in the lumbar segment, 5 pairs in the sacral segment, and 1 pair in the caudal nerve. The spinal cord is the primary center of the reflexes of muscles, glands and internal organs, and the intermediate unit that closely links the activities of the various parts of the body with those of the brain. Early diagnosis of spinal cord tumors is extremely important. If you are familiar with their early clinical manifestations, you can make a diagnosis and give timely treatment before the spinal cord is seriously compressed, and then you can achieve a better therapeutic effect. In general, the basic clinical manifestations of intraspinal tumors are segmental neurological symptoms and spinal cord compression symptoms below the plane of compression. Among the early symptoms, radicular pain is the most common, followed by motor sensory disorders, such as limb muscle atrophy, loss of muscle strength, and urinary and defecation dysfunction. Early symptoms of extramedullary tumors are usually caused by compression of the nerve roots, with abnormal pain and temperature sensation, followed by loss of pain and temperature sensation, muscle atrophy, and sensory and motor symptoms that correspond to the innervation area of the affected nerve roots. With further tumor growth and compression of the spinal cord, superficial and tactile sensory deficits occur below the level of the lesion. Loss of sphincter control can lead to incontinence. Depending on the localization of the tumor and the nature of the tumor, spinal cord symptoms can be mild or severe and are often bilaterally asymmetric. If the tumor compresses the blood vessels of the spinal cord and causes vascular occlusion, the spinal cord can be softened and the patient may even become paraplegic. The most common intramedullary tumors are gliomas and ventricular meningiomas, which tend to extend to several segments of the spinal cord. Clinical manifestations may be similar to those of spinal cord cavernous disease, and may include progressive bilateral paralysis, loss of sensation, and urinary and fecal dysfunction. Tumors confined to one segment may clinically resemble an extramedullary tumor, but pain is usually unremarkable and symptoms of urinary and fecal dysfunction appear earlier. Neurologic localization signs: i.e., neurologic signs of lesions in different segments of the spinal cord. (1) Cervical spinal canal tumor: lesions in the upper cervical medullary region may have occipital and cervical pain and sensory abnormalities. Spastic quadriplegia and hyperreflexia of biceps tendon can be seen below the lesion segment. Lesions of the 5th cervical medulla may cause atrophic paralysis of the deltoid and biceps muscles. Sensory deficits extend to the lateral aspect of the arm, and biceps and piriformis reflexes are absent. The 6th cervical myelopathy causes paralysis of the triceps brachii and wrist extensors, and the patient may develop a partial wrist drop. The 7th cervical cord lesion may cause paralysis of the wrist flexors and finger flexors and extensors, with sensory deficits involving the medial aspect of the midline of the arm. The 8th cervical myelopathy may cause intrinsic muscular atrophic palsy of the hand, claw-shaped hand deformity of the ring and little finger, and sensory disturbances involving the medial side of the arm. (2) Thoracic spinal canal tumor: clinical localization usually relies on the level of sensory impairment, and it is difficult to judge by virtue of intercostal muscle strength. Patients may have paralysis of the lower abdominal muscles, and the upper abdominal muscles are normal, so when the patient lies supine and sits up against the resistance exerted by the chest, the umbilicus moves upward, and the lower abdominal wall reflex disappears. Most patients with thoracic spinal canal tumor may have obvious sensation of thoracic and abdominal girdle. (3) Lumbar spinal canal tumor: when the tumor involves the 1st and 2nd lumbar medulla, it will cause loss of reflex. When the 3rd and 4th lumbar medullary lesions do not involve the cauda equina nerve root, the quadriceps muscle will be weakened, the knee reflex will disappear, while the Achilles tendon reflex will be hyperactive and ankle clonus will appear. If the cauda equina of the spinal cord is involved at the same time, it may manifest as spastic paralysis of the calf on one side and chiropractic paralysis on the other side. (4) Cone and cauda equina: early symptoms may include low back pain, saddle area and lower limb pain or numbness, often diagnosed as sciatica. Urinary and faecal dysfunction appears earlier. Lower limb spastic paralysis, muscle atrophy, foot drop, sensory loss in the lumbosacral dermatomes, especially in the saddle area, and occasional lumbosacral, hip, hip or heel ulcers may occur.