(Figure: microscopic resection of intradural tumor under electrophysiological monitoring) Jun Xu, Department of Neurosurgery, General Hospital of Ningxia Medical University Intradural tumor (spinal cord tumor) is a primary or metastatic tumor that occurs in the spinal cord itself and in the tissues adjacent to the spinal cord within the spinal canal. Tumors can occur in any segment from the cervical cord to the cauda equina. The most frequent occurrence is in the thoracic segment. Extramedullary benign tumors are the most common intravertebral tumors. The main symptoms are nerve root pain, as well as sensory and motor deficits below the lesioned segment, which can lead to complete paralysis in severe cases. Magnetic resonance imaging (MRI) of the spinal cord can determine the location, size, number and relationship of the tumor to the spinal cord. The only effective treatment for intravertebral tumors is surgical resection. Given that 3/4 of intravertebral tumors are benign, the prognosis is generally good after total removal of the tumor. The spinal cord is the primary center of muscular, glandular and visceral reflexes, the intermediate unit that closely links the activities of all parts of the body with those of the brain. Because of its special location, anatomical structure and physiological characteristics, the spinal cord has a very poor blood supply, and because it is part of the central nervous system, it is more delicate and fragile than any other tissue in the body. Therefore, patients with spinal cord tumors should seek medical treatment from qualified and experienced medical institutions and specialized doctors as much as possible. The spinal cord is particularly vulnerable to spinal cord injury if there is a spinal canal occupancy, and as the disease progresses, signs and symptoms such as sensory loss, urinary and fecal incontinence, sexual dysfunction or loss, hemiplegia, paraplegia, etc. may gradually appear. Therefore, we should strive for surgical resection of intravertebral tumors, even if they cannot be removed completely, partial or partial resection should be performed to reduce or relieve the compression and damage of the tumor on the spinal cord. Once the diagnosis is clear, regardless of the degree of spinal cord compression, surgery should be performed in a timely manner. With the progress of diagnostic equipment, the improvement of surgical equipment and instruments, and the continuous improvement of surgical skills, the success rate and safety of resection of intravertebral tumor have been greatly improved. Neurosurgery is a discipline that treats diseases of the brain, spinal cord and peripheral nervous system by surgical methods, and is a high, precise and advanced discipline in the field of medicine, recognized as the highest status in medicine. Neurosurgeons operate under a large operating microscope, and the surgery is microsurgery, which can see the finer blood vessels, nerves and other tissue structures under the microscope, to achieve the most minimally invasive and total removal of the tumor as possible. In China, due to the imbalance of regional development, many places do not have neurosurgery or weak foundation of neurosurgery, and many orthopedic surgeons in hospitals are doing intravertebral tumor, which is done under the naked eye. There is a high chance of damage to spinal cord and surrounding structures, and easy to residual tumor. Statistics show that the effect of surgery is not the same, and the residual tumor is easy to recur faster. Therefore, it is recommended that patients with intravertebral tumors should always be seen in neurosurgery. We also hope that some other doctors will suggest patients to go to neurosurgery in a responsible attitude to patients. At present, the neurosurgery spinal cord group of Ningxia Medical University General Hospital is mainly in the neurosurgery department of the Cardiovascular and Cerebrovascular Disease Hospital (a public tertiary level hospital). The annual number of spinal cord cases in Ningxia should be about 150 cases. Initially, in 2011, our department (General Hospital + Heart Hospital) did more than 50 cases of spinal cord tumors, and in 2012, our department divided into specialized spinal cord tumor groups and did more than 70 cases, among which the neurosurgery spinal cord tumor treatment group of the Heart and Cerebrovascular Hospital did more than 40 cases. The surgery is done under “C” arm positioning, electrophysiological monitoring and surgical microscope, so that the positioning is accurate, the incision is small, the damage to tissues and spine is small, and the postoperative recovery is fast. At present, none of the patients have serious nerve injury and complications after surgery. It has reached the domestic advanced level. As the patients’ knowledge and understanding of specialized hospitals for cardiovascular and cerebrovascular diseases and the awareness of the risks of spinal cord tumor surgery increase, we believe that patients will definitely choose qualified and high level hospitals, doctors and neurosurgery departments to perform the surgery. Add: In 2013, we performed nearly 100 cases of spinal cord tumor surgery, nearly 70 cases in its central hospital, no one case of aggravated injury, all achieved good results. 2013, the neurosurgery department of the Hospital for Cardiovascular and Cerebrovascular Diseases carried out new technology and new business to improve the surgery for patients with spinal cord tumor, the previous surgery will bite away all the spinous process and vertebral plate with biting forceps, resulting in the stability of the spine is damaged, and the patient’s future activities are limited. Now we perform only lamellar opening for small tumors and full lamellar and spinous process repositioning and fixation for large tumors after surgery, which preserves the integrity and stability of spinal anatomy and results in fast recovery and good stability of the spine for patients after surgery. (2014.2.18.) This emphasis on surgery of intravertebral tumors is no less demanding than the surgical operation of brain tumors, if not more so. —- Zhao Jizong