Spinal cord tumors are one of the most important causes of spinal cord and cauda equina compression, including tumors that occur in the spinal canal and adjacent tissue structures of the spinal cord. The incidence of primary spinal cord tumors is 2.5 per 100,000 population per year, and the incidence is similar for both sexes, except that spinal meningiomas are more common in females and ventricular meningiomas are often more common in males. The incidence of thoracic spinal cord is higher, but the incidence is approximately the same according to the ratio of length of each segment. The early symptoms are usually caused by the compression of nerve roots, pain and abnormal sensation, followed by sensory loss, muscle weakness and atrophy, and the range of sensory and motor symptoms are in accordance with the innervation area of the affected nerve roots. Further tumor growth produces compression of the spinal cord, producing progressive ankylosing limb paralysis with superficial superficial sensory and proprioceptive deficits below the level of the lesion. Loss of sphincter control may result in retention or incontinence of urine and stool. Depending on the localization of the tumor and the nature of the tumor, symptoms in the spinal cord can be mild or severe and are often bilateral and asymmetric. If the tumor compresses the blood vessels of the spinal cord and causes vascular occlusion, it can cause spinal cord softening and produce symptoms of spinal cord transection. Intramedullary tumors (glioma, ventricular meningioma) are mainly astrocytomas and ventricular meningiomas, which account for about 20% of all spinal cord tumors, and extend to several spinal cord segments. Progressive bilateral hypoparesis, sensory loss, and sphincter dysfunction may occur. A tumor confined to one segment can be clinically similar to an extramedullary tumor, but the pain is usually not significant, and the symptoms of sphincter dysfunction appear earlier. Differential diagnosis Spinal cord tumors need to be differentiated from other spinal cord disorders, such as adhesive arachnoiditis, multiple sclerosis, amyotrophic lateral sclerosis, and spinal cavernous disease. The orthopedic diseases that need to be differentiated are spinal tuberculosis and degenerative disease of the spine. Spinal radiographs may show bone destruction, widening of the pedicle spacing or deformation of the paravertebral tissue, cerebrospinal fluid protein quantification is usually elevated, and spinal cavity dynamometry shows the presence of obstruction in the subarachnoid space. If complete obstruction is present, lumbar puncture is risky and imaging should be performed first. MRI of spinal cord tumors can provide confirmation of the diagnosis, although occasionally CT spine imaging is needed, especially to identify tumors outside the dura, and CT spine imaging may provide the first clue that the lesion is an arteriovenous malformation, which can be confirmed by selective arteriography. 1, spinal structural disease mostly has chronic toxic symptoms such as low fever and night sweats, lesions mostly erode the intervertebral discs with the corresponding vertebral margins, and paravertebral cold abscesses help in the differential diagnosis. 2, degenerative spondylosis due to intervertebral discs, ligaments protruding into the spinal canal causing spinal cord and nerve compression. Imaging signs of spinal degeneration are almost always present after middle age, and the differential diagnosis of spinal cord tumors depends on careful neurological evaluation, supplemented by imaging.