Ms. Shen, 44 years old, had a tumor found on her uterus 2 years ago and underwent excision of the uterine tumor, and the postoperative pathology report was uterine smooth muscle sarcoma. 2 weeks later, Ms. Shen was hospitalized again for total lymph node dissection of the uterus. Sarcoma is a malignant tumor originating from mesenchymal tissue (including connective tissue and muscle) and tends to be more malignant. Therefore, radiotherapy and chemotherapy were done again after surgery. Six months ago, Ms. Shen discovered another lung metastasis and had her lung lesion removed under thoracoscopy. Unfortunately, Ms. Shen gradually developed pain and weakness in her right upper limb and gradually became unstable in walking. The MRI of the cervical spine revealed complete destruction of the cervical 6 vertebrae, and paralysis could occur at any time. As seen on the CT of the cervical spine, the cervical vertebral body was collapsed and there was a large mass in the right soft tissue. The cervical spine was previously treated as a no-life zone, where paraplegia or even death could occur at the slightest mistake. Does it still make sense to operate on this patient? The orthopedic department of Ningbo First Hospital discussed this case and concluded that: the patient is young and in fair general condition, although the malignancy is high, and life expectancy is > six months if the neck tumor is removed. Without surgery, total paralysis would soon occur, the patient would not be able to walk, hand function would be impaired, and the respiratory center would be affected, which could be life-threatening at any time. The patient and the patient’s family followed the doctor’s advice and decided to have surgery. Dr. Lu Yong, a spine surgeon at Ningbo First Hospital, has been practicing medicine for more than 30 years and is very experienced. In order to ensure the success of the surgery, he also invited Professor Yan Wangjun, a spine tumor specialist from Shanghai Long March Hospital, to perform the surgery together. Since the tumor had invaded the patient’s right vertebral artery and the vertebral artery was encapsulated in the tumor tissue, the surgery was very difficult. The patient was first placed in supine position to remove the vertebral body in front and the mass in the right soft tissue, and then changed to prone position to remove the tumor in the back. After 3 hours of “bloodbath”, the operation was very successful. After the operation, the patient’s right upper limb pain was significantly reduced and he started to walk in bed one week after the operation, and his muscle strength was significantly stronger than before the operation. Recently, the patient was discharged from the hospital successfully. The picture above shows the X-ray review after the combined anterior-posterior cervical laminectomy and reconstruction of cervical 6 vertebrae. The complete success of this operation shows that the technology of spine surgery in Ningbo First Hospital still maintains the leading level in China. For malignant tumors with spinal metastases, the decision to operate is based on the patient’s life expectancy, whether the metastatic lesions are single or multiple, and the patient’s general condition. Generally, patients with life expectancy of more than 3-6 months, non-multiple metastases (more obvious ones) and good general condition of the patient should take active surgical treatment instead of delaying and waiting. So as not to miss the best time for surgery.