Intravertebral occupational disease accounts for about 10-15% of neurological tumors and is a common disease in neurosurgery, for which surgery is the only effective treatment. The surgical approach for resection of intravertebral occupancy varies depending on the location, size, and surrounding structures of the occupying lesion, and in the past, most intravertebral occupancies were treated by total laminectomy. However, with the recent emphasis on spinal stability and the popularization of minimally invasive concepts, there have been many improvements in the surgical approach to intravertebral occupational disease. There is a growing interest in the hemi-laminar approach for resection of intraspinal space-occupying disease. Spinal cord disease is an important part of neurosurgery, but in the past, most of the traditional neurosurgical work has focused on the resection of lesions with insufficient understanding of the impact on spinal stability, resulting in some adverse outcomes. The prevailing theory of spinal stability is the three-column theory proposed by Denis, which states that the stability of the spine is composed of the anterior, middle, and posterior columns, with the muscles and ligaments in the posterior column playing an important role in stabilizing and supporting the spine, as well as the bone. The muscles and ligaments maintain the fine movements and posture of the spine through neural reflex regulation, which regulates the balance of load and maintains stability. In the past, total laminectomy not only removed the spinous process, but also destroyed the muscles and ligaments attached to the spinous process, which had an impact on the stability of the spine. As a result, posterior derangement of the spine is often seen in these patients, and even though there is no obvious posterior derangement on imaging, the damage should be extensive posteriorly so many patients have complaints of localized pain and discomfort. The literature reports that 20% of patients with total laminectomy for intradural tumors have some spinal instability. Therefore, yasagil suggests that a hemi-laminar approach is the recommended method for resection of tumors. The hemi-laminar approach has less impact on the stability of the spine than the traditional total laminectomy approach because it restricts the bone window to one side of the lamina without destroying the contralateral muscle attachment points, supraspinous ligaments, and interspinous ligaments, and maximizes the preservation of the annulus and posterior column of the spine. Many scholars at home and abroad have carried out hemi-laminar approach surgery, and through follow-up of patients with tumors removed by hemi-laminar approach, it is believed that hemi-laminar can better maintain the sequence and curvature of the spine, and the impact on the stability of the spine is very mild. Some other scholars have made some improvements on this basis to reduce the surgical damage to a lower level. Although the hemivertebral approach has obvious advantages in maintaining the stability of the spine, it requires a high degree of surgical skill because of the narrow field, and particular attention should be paid to the protection of the synovial joint during surgery. The microscopically assisted hemivertebral approach is currently considered to be satisfactory for the majority of extramedullary tumors in the spinal canal, but it is difficult to use the hemivertebral plate for tumors that are too large, especially those that are hemorrhagic and cannot be resected in pieces. At present, some scholars also use the hemivertebral plate approach to resect intramedullary tumors, but most of the cases in this group are extramedullary tumors, and the only two intramedullary tumors are ventricular meningioma with terminal filaments and ventricular meningioma with eccentric growth. For most of the intramedullary tumors, we still advocate a total laminectomy approach. In our group, all 65 patients achieved total resection of the tumor, and the operative time and intraoperative bleeding were significantly less than those with total laminectomy. Patients got out of bed early after surgery to reduce the time of bed rest. There were two complications in this group, which were not significantly elevated compared with the total laminectomy approach. In conclusion, the hemi-laminar approach can be used to remove tumors in the spinal canal and has the advantage of less surgical damage and better maintenance of spinal stability compared with the total laminectomy approach. However, the application of this approach requires high operational skills and strict control of the indications, and should not be minimally invasive for the sake of minimally invasive, as protection of spinal cord function is the core principle in surgery for intradural occupancy disease.