It is well known that the spine plays an extremely important role in maintaining the stability and movement of the human body. In 1983, Denis proposed the concept of the three-column theory of the spine, i.e., the anterior longitudinal ligament, the anterior part of the vertebral body and the anterior part of the annulus fibrosus make up the anterior column; the posterior longitudinal ligament, the posterior part of the vertebral body and the posterior part of the annulus fibrosus make up the middle column; and the vertebral roots, the ligamentum flavum, the articular capsule and interspinous ligaments make up the posterior column. This theory lays the foundation for further understanding of the biomechanical characteristics of the spine. At present, most neurosurgeons in China still use posterior median approach laminotomy tumor resection when treating intraspinal tumors. This procedure requires at least incision of the interspinous ligament and bilateral muscle attachment points, resection of part of the spinous process, vertebral plate and ligamentum flavum, and in some cases, resection of part of the articular eminence, thus destroying the integrity of the posterior column, which in turn affects the stability of the spinal column, and requires one month’s bed rest in the near future after the operation, and in the long term, it is possible to cause kyphosis of the spinal column. In order to avoid the occurrence of this long-term complication, some doctors use posterior window opening and plate reset fixation. This kind of surgery theoretically has the potential to avoid long-term kyphosis, but the stability of the spine in the early postoperative period is still poor, and the implantation of the material will also increase the cost of medical care. The hemispinal approach is a new technique that has been developed in recent years. To remove an intradural extramedullary tumor with this technique, only one side of the muscle attachment point needs to be separated and retracted, one side of the vertebral plate and the ligamentum flavum needs to be removed, and part of the articular eminence needs to be removed if necessary, and the dura mater needs to be opened under the microscope to remove the tumor. In this way, the interspinous ligament and spinous process, the vertebral plate, the contralateral muscle attachment point and the lateral articular eminence can be preserved, thus maximizing the integrity of the posterior part of the vertebral body, and playing a great role in maintaining the stability of the spine in the postoperative period. In conclusion, the transforaminal approach for resection of intramedullary tumors has the advantages of less intraoperative bleeding, less impact on spinal stability, early postoperative mobility and shorter hospitalization time, and reduces postoperative complications such as spinal instability and long-term kyphosis, which has been widely used in clinical practice. Therefore, hemilaminectomy should be chosen in the treatment of intradural extramedullary tumors.