The thoracolumbar spine is a high incidence site for spinal tumors. The special anatomical structure of the spine makes extensive resection of spinal tumors far more difficult than the treatment of extremity tumors. Traditional surgical treatment is based on lesion scraping or resection of tumor in blocks, which is prone to recurrence. Whole spine resection can significantly reduce postoperative local recurrence, improve patients’ quality of life, and facilitate the development of comprehensive treatment. At present, the surgical treatment of thoracolumbar spine tumors is still controversial, and the choice of surgical modality is arbitrary and blind. This article reviews the surgical resection, surgical staging and surgical approach for primary and metastatic tumors of the thoracolumbar spine. The technique of total spine resection has been continuously improved by many scholars to achieve the standard of extensive and marginal tumor resection, and a lot of biomechanical and clinical application studies have been conducted on the way of spinal reconstruction after tumor resection to achieve postoperative reconstruction of spinal stability and functional recovery. However, total spine resection is still an extremely complex and high-risk procedure, and we need to carefully grasp the surgical indications to avoid expanding the surgery and causing unnecessary pain and trauma to patients. Primary malignant and invasive tumors should be resected as much as possible, while patients with isolated metastatic tumors that have a long survival period can also be resected as a whole, and multiple metastatic tumors should not be resected as a whole. Tumors with unilateral arch root involvement can be resected in the oncologic sense, while tumors with bilateral arch root involvement can only be resected in the anatomic sense. How to achieve more convenient and safe extensive or marginal resection of spinal tumors, reduce surgical trauma, provide strong fixation and preserve more spinal functions, and improve the survival time and quality of life of patients with a combination of adjuvant therapy will be the direction of research in spinal tumor treatment.