The spine is the most vulnerable site in the skeletal system for metastases, with 70% occurring in the thoracic spine, 20% in the lumbar spine, and 10% in the cervical spine. Disruption of the vertebral body by metastases can cause severe pain, epidural spinal cord compression, and result in sensory and motor dysfunction. Previously, most spinal metastases were treated with radiation therapy, but results from prospective randomized clinical trials have shown that spinal cord surround decompression and internal spinal fixation for metastases, combined with postoperative radiation therapy compared with radiation therapy alone, significantly increased the proportion of patients able to walk after treatment, maintained sphincter function and muscle strength, and prolonged survival time. The main factor determining the prognosis of patients with spinal metastases is the pathological type of the primary tumor, with breast, prostate, myeloma, thyroid, and kidney cancers having a better prognosis. 80% of patients with spinal metastases can benefit from surgical treatment. Therefore, patients with a better prognosis should undergo aggressive surgical treatment.