As the pace of social life continues to accelerate, low back pain has become a common disease of modern people, especially some middle-aged and elderly people, think that low back pain is a common disease such as osteoporosis, lumbar disc protrusion. The actual fact is that, behind the phenomenon of low back pain, there may be a hidden spinal tumor killing machine. The spinal tumor is more malignant than benign. The spinal tumor is divided into two categories: primary and metastatic. Primary tumors of the spine refer to tumors growing out of the spine itself; metastatic tumors of the spine refer to tumors transferred from malignant tumors in other parts of the body through blood circulation, called metastases. There is no characteristic manifestation of spinal tumor. Initially, it is often local discomfort and intermittent vague pain, which can be relieved by rest or general painkiller treatment. The pain is located below the plane of the lesion and cannot be easily localized. Later, the pain becomes persistent and severe, which is difficult to be relieved by medication, and the symptoms of spinal cord or nerve compression gradually appear, such as weakness of legs, hypesthesia, followed by difficulty in movement, urinary and fecal incontinence, and lower limb paralysis. For middle-aged and elderly patients with progressive and persistent low back pain with nocturnal pain, they should be alerted to the presence of spinal tumors. Second, the nature of pain is difficult to distinguish and easy to misdiagnose. Complications of spinal cord and nerve root damage often appear in the early stage when the tumor keeps growing, including pathological fracture due to the destruction of spinal strength by the tumor, and the compression of spinal cord and nerve root by the tumor itself, causing severe local pain or even limb paralysis, which seriously affects the patient’s quality of life. Back pain is the most common symptom in patients with spinal metastases, often preceding other neurological symptoms by weeks or months. Patients with spinal tumors can see two different types of back pain: tumor-related pain and mechanical pain. Tumor-related pain is primarily nocturnal or early morning pain and is usually relieved by activity during the day. Mechanical pain arises from structural abnormalities of the spine, such as pathologic compression fractures that lead to instability of the spine. This pain is motion-related, and is exacerbated by increased longitudinal load on the spine in a sitting or standing position. Spinal tumors are often misdiagnosed or underdiagnosed, and sometimes even physicians are confused by the appearance of pain. This is because cancer pain and low back pain feel similar and can only be observed on X-ray when the bone is severely damaged and decalcification reaches 50% to 70% during the examination. Therefore, for persistent low back pain, several examinations such as CT, MRI, ECT and puncture biopsy should be performed to exclude the possibility of spinal tumor. PET/CT examination is the most advanced imaging examination at present, which helps to detect lesions and characterize them at an early stage, but it is more expensive. Spinal metastasis symbolizes the advanced stage of tumor, and many patients often treat it negatively in the past. However, because the related nerve structures of patients are compressed by the tumor, they will feel great pain or even paralysis will occur, and the quality of life is extremely poor. For spinal metastases, comprehensive treatment options such as surgery, radiotherapy, chemotherapy and biotherapy are currently used. In particular, with improved spinal surgery techniques and improved surgical instruments, surgery can help restore or preserve adequate nerve function, relieve pain and ensure immediate or permanent spinal stability, which gives patients added confidence in fighting cancer and strengthens their belief in living. In this respect, the surgical treatment of metastases has important implications.