Tumor patients are the diseases with the highest incidence and mortality rate at present, and about 50-70% of malignant tumor (cancer) patients will have bone metastasis, while the spine is the common site of bone metastatic cancer, accounting for about 40% of metastatic cancer patients. The most common sites of spinal tumors are: 85% of vertebral body, 10%-15% of adnexa, and 5% of intra- and extra-vertebral canal. Diseases that most commonly develop metastatic cancer of the spine are: breast cancer, lung cancer and prostate cancer. This is followed by kidney cancer, gastrointestinal tumors, thyroid cancer, lymphoma and myeloma. The incidence of metastatic cancer of the spine is still increasing with the development of available detection methods, the increase of anti-cancer methods and the prolongation of patient survival. About 10% of patients with metastatic cancer of spine will have clinical symptoms, mainly manifested as low back pain, which is categorized into the following three kinds: 1. Resting pain. Patients manifest persistent low back pain, which is often more obvious at night. This is more obvious in the advanced stage of the tumor. It is mainly caused by the expansive growth of tumor cells, which compresses the surrounding periosteum, nerve endings in the bone marrow cavity and sinus vertebral nerve. 2.Motion pain. The patient manifests as severe pain in the lumbar back when the position changes, such as turning over, sitting up, lying down and other activities. It is mainly caused by tumor cells destroying vertebral bone trabeculae and bone cortex, leading to pathological fracture of vertebral body and causing damage to the biomechanical stability of the spine. Neuralgia. The patient manifests intolerable and persistent pain, which often radiates to the chest, abdomen or lower limbs. Serious complications such as paralysis occur in severe cases. It is mainly caused by tumor cells compressing and stimulating nerve roots and spinal cord. The treatment for spinal metastatic cancer patients is mainly to relieve pain and prevent paralysis. According to the cause of pain and the limited survival time of patients, the treatment is mainly through comprehensive conservative means such as chemotherapy for primary disease, radiotherapy for spinal metastases and application of diphosphate. However, 1%-2% of patients still need surgical intervention. At present, the purposes of surgical treatment for spinal metastatic cancer are: 1) decompression of spinal cord or nerve roots to relieve pain and restore the integrity of spinal cord; 2) restoration of biomechanical stability of spine; 3) clear diagnosis. For spinal lesions that are difficult to diagnose by other clinical means, the lesions can be incised and biopsied or removed by surgical means. The ultimate goal of surgery is to improve the quality of survival within the limited survival time of patients. At present, surgical treatments for metastatic cancer of spine include: 1. Simple spinal decompression. The commonly used method is laminectomy. This method was a frequently used treatment before 1980s. However, because the most frequent sites of spinal metastatic cancer are vertebral body and pedicle root. The resection of spinal attachments destroys the stability of spine, which leads to poor surgical effect, even inferior to the efficacy of conservative treatment, and thus once caused the situation of “talking about surgery”. Vertebral tumor resection and reconstruction. With people’s recognition of Danis’ theory of three-column structure of spine, the treatment of metastatic cancer of spine now is spinal lesion scraping or total vertebral resection, in order to perform partial or complete resection of the lesion. The surgery is accompanied by reconstruction of the postoperative vertebral defect using titanium mesh or artificial vertebrae that are more compatible with the body. The procedure often requires a posterior pedicle screw system or an anterior nail rod system in the spine to increase spinal firmness in adjacent segments. Biomechanical stability of the spine is restored immediately after surgery, pain relief is unequivocal, and the patient is out of bed and able to perform normal activities of daily living within a short period of time after surgery. Complications of loosening or breakage of the prosthesis and internal fixation are less likely to occur during the patient’s survival period, and the long-term effect is good. However, the surgery is traumatic, high cost of surgery, coupled with the short survival time of the patient, it is often difficult to be accepted by the patient and his family, and even clinical staff. 3.Spinal filler surgery. At present, the more commonly used method is percutaneous or intraoperative vertebral puncture cement molding or balloon expansion molding. The principle of this surgery is to use hardness, plasticity and good medical bone cement to fill the medullary cavity of the vertebral body destroyed by the tumor, so as to restore the rigidity of the vertebral body itself; in addition, the bone cement has the purpose of partially killing the tumor cells, so as to play the role of local “chemotherapy”. This method is easy to operate, with little damage to the patient, low cost, and can even be done in the outpatient clinic, and the surgical effect is immediate, so it is very easy to be accepted by the patients and their families. However, the most serious complication of this surgery is the leakage of bone cement, especially to the spinal canal and blood vessels, which can lead to spinal cord compression, paralysis or even death in severe cases. Therefore, there are strict indications for the surgery, especially the requirement that the posterior wall of the diseased vertebra should be intact, and it should be clear that there is no vascular breakage around the puncture site and no connection with the large blood vessels before the cement is injected. 4.Other minimally invasive treatment of the diseased spine. At present, the more commonly used methods are vertebral body puncture, heat therapy at the lesion site, chemotherapy, radiotherapy and so on. Such as radiofrequency ablation at the lesion, argon helium knife treatment, radioactive ion implantation, adriamycin liposome implantation and so on. These methods are often difficult to be widely carried out due to the limitation of corresponding equipment. And the effect is not the same with different tumor growth habit. More and more clinical studies have shown that the effect of surgery combined with adjuvant radiotherapy is significantly better than that of radiotherapy alone. Its advantages are mainly manifested as: patients’ bed rest time is significantly shortened, pain is significantly reduced, the rate of paralysis is significantly reduced, and the ability and confidence of their daily life are significantly improved. Moreover, with the diversification and simplification of treatment means, more and more spinal metastatic cancer patients are gradually accepting active surgical interventions. Pain-free and normalized life is gradually becoming the survival goal of spinal metastatic cancer patients.