Spinal surgery is an important branch of surgery, spinal surgery began in the early 20th century, in 1905, Cushing reported a case of intramedullary tumor resection. 1909, Openheim reported a case of L5/S1 discectomy. After that, various surgical treatments for spinal diseases and various approaches were reported one after another, and spinal surgery was gradually carried out. In the early days, due to the backwardness of imaging technology, surgical technology and insufficient knowledge of spinal stability, the accuracy of diagnosis of spinal cord diseases in clinical work was poor, the effect of surgical treatment was not good, and complications such as spinal cord injuries and spinal deformities often occurred after surgery. Until Hounsfield invented CT in 1973, this was the first major leap in the history of the development of spinal surgery. In 1977, the application of MRI in the field of neurology became the 2nd leap in spinal surgery. It can be said that the emergence of CT and MRI brought a milestone in the development of spinal cord surgery. 1983 Denis put forward the “three columns theory of the spine”, which became the mechanical basis for guiding spinal surgery. On the basis of this theory, with the development and combination of engineering and material science, and the innovation of surgical instruments, new materials, new technologies and new methods are constantly emerging and can be applied to the clinic, such as Harringtong rods, “U”-shaped vertebral body plates, Luque rods, Ziele “L”-shaped vertebral body plates, and so on. Harringtong rods, “U”-shaped vertebral body plates, Luque rods, Ziele “L”-shaped vertebral body plates, cervical spine plates, Cagetechnology, transpedicular screws, transpedicular screws, CD systems, artificial intervertebral discs and so on have been widely popularized and applied, and the spinal surgery has achieved rapid development, especially in the last 10 years or so, the development of spinal and myelopathy surgery has been rapidly changing, and the speed of the development has been astonishing. All along, regarding spinal cord diseases, in many people’s concept, the lesions outside the dura mater belong to the orthopedic treatment category, and the lesions inside the dura mater belong to the neurosurgery. In fact, spinal surgery is a typical cross-discipline, which includes both the bony structures of the spine, as well as the central nervous system of the spinal cord and spinal nerve structures. Since neurosurgery started late in China, the treatment of spinal surgical diseases was basically undertaken by orthopedic surgeons in the past. Although some neurosurgical predecessors started spinal surgery at the beginning of the founding of the country, the percentage of which was very small and the surgery was mainly focused on the resection of tumors in the spinal canal. One of the main reasons is that neurosurgeons are more concerned about the protection of the spinal cord and nerves, and have given less consideration to the stability aspect of the spine, or have little understanding of the biomechanical structure of the spine and internal fixation techniques. In the past, it was mostly simple to bite off the vertebral plate, or even bite off the vertebral plate of multiple segments, and after many years, it was found that many of these patients developed spinal deformity. So neglecting spinal stability became the biggest problem for neurosurgeons in spinal cord surgery in the past. Neurosurgeons began to reflect on this, began to stand in a comprehensive, holistic perspective to recognize spinal cord diseases, and began to learn new techniques and theories in spinal fixation. At present, some large hospitals in China have set up spinal cord neurosurgery treatment centers, combining neuromicrographic surgery technology and internal fixation technology, and have achieved excellent results in the surgical treatment of spinal cord diseases. In Europe and the United States, spinal diseases are mostly attributed to neurosurgery, neurosurgeons are committed to the field of spinal surgery, spinal cord diseases in many large neurosurgery centers, accounting for more than 30%-40% of the total volume of surgery, and some even accounted for 60%-80% of the development of spinal surgery in the history of the neurosurgeon’s figure, Cloward, Goel, Bryan, Neurosurgeons such as Cloward, Goel, Bryan, Laheri, etc. have made great contributions to the development of spinal fixation materials. In 2000, the American Association of Neurological Surgeons’ journal, JNeurosurgery, formally published the spine fascicle, J Neurosurgery: Spine. More than a decade ago, Taiwan was similar to the situation in mainland China, where spine surgery was basically categorized as orthopedic treatment. However, through the joint efforts of neurosurgeons, spinal deformities, spinal cord tumors, herniated discs, spinal cord injuries, and other surgeries are almost all undertaken by neurosurgeons, and the Neurological and Spinal Surgery Society has been established. The main reason for the current situation that spinal surgery is undertaken by orthopedic surgeons in China is that neurosurgery in China started late, and neurosurgeons have been committed to learning and catching up with the developed countries in the world in brain surgery for a long time, so they have no time to take care of spinal surgery. Now with the rapid improvement of China’s neurosurgery level, some of the large domestic neurosurgical units of the medical level has been in line with the international neurosurgery, neurosurgeons are gradually aware of the lack of spinal surgery, and began to pay attention to the research and treatment of spinal spine diseases, is committed to make up for the historical legacy of this shortcoming. At present, the Association of Neurological Surgeons has established a spinal neurosurgery section, which will greatly encourage neurosurgeons to engage in spinal surgery, and ultimately play a positive role in promoting the development of spinal neurosurgery. The American Association of Neurological Surgeons defines neurosurgery as the diagnosis and treatment of the central, peripheral and autonomic nervous system and its supporting structures. The Chinese Society of Neurological Surgery also clearly points out that the diagnosis and treatment of spinal cord diseases belongs to the professional category of neurosurgery. This lays the foundation for neurosurgeons to perform spinal surgery. As we all know, the spine and the spinal cord are inseparable and interdependent, just like the relationship between the skull and the brain. The brain and spinal cord belong to the central nervous system, and the cranium is the support structure of the brain, which belongs to the scope of neurosurgery. The spine, as the support structure of the spinal cord, is also an important branch of neurosurgery. Moreover, neurosurgeons are more familiar with neuroanatomy and neurophysiology, and pay more attention to the protection of nerve tissues. In particular, with the widespread use of microscopic technology in neurosurgery, neurosurgeons can perform more delicate operations with higher surgical safety. Therefore, in Europe and the United States spinal spinal surgery is mostly undertaken by neurosurgeons. Spinal surgery mainly includes: 1, degenerative diseases of the spine, such as cervical spondylosis, lumbar disc herniation, etc., these most common diseases account for more than 80% of all kinds of spinal surgery; 2, spinal trauma; 3, spinal tumor; 4, spinal deformity. In addition to spinal deformity surgery, other spinal surgery can be summarized into two aspects, namely decompression and fixation. It has been reported that incomplete decompression is the main reason for the poor efficacy of cervical spondylosis surgery, and the serious complications and even deaths caused by high cervical surgery are mostly related to surgical operations, while neurosurgeons can give full play to their specialties through microscopic operation techniques in this aspect. Neurosurgery and orthopedics have their own strengths in spinal surgery. Neurosurgeons are good at protecting the spinal cord and nerves, while orthopedic surgeons are better at stabilizing the spine. Spinal neurosurgery must combine the two, analyzing and treating from a holistic perspective. A spinal neurosurgeon must have formal specialized training, and the transition from microsurgery within the spinal cord to disc surgery for a neurosurgeon is clearly different from the transition from disc surgery to spinal microsurgery for an orthopedic surgeon. Neurosurgeons with microsurgical skills, combined with a different training background and a deeper understanding of the anatomy and physiology of spinal nerves, are uniquely positioned to deal with the spinal cord and nerve decompression. Spinal stability seems to be the weak point of neurosurgery. In fact, neurosurgeons can not only maintain and restore the stability of the spine through internal fixation devices, but also reduce the scope of spinal canal opening and surgical trauma to the spine through microsurgical techniques, thus minimizing the impact on the stability of the spine. It can be said that although neurosurgeons also need training in internal spinal fixation, it is not a difficult task compared to microsurgical techniques, while the transition from orthopedics to spinal neurosurgery requires special training. At present, a few large neurosurgery centers in China have already established spinal neurosurgery specialties and have done a lot of work with very promising results. The Neurosurgery Department of Tang Du Hospital set up a spinal neurosurgery treatment center in 2010, despising the one-sided views and practices of the past, which only focused on spinal nerves but not spinal structure; only focused on removing tumors but not preserving the vertebral plates; and only focused on spinal cord function but not spinal stability. We adhere to the principle of combining minimally invasive microsurgery and maintaining spinal stability, organically combining neurosurgical microscopic techniques and internal spinal fixation techniques to achieve the perfect effect of relieving patients’ pain and maintaining spinal stability. So far, we have completed a large number of spinal canal tumor surgeries, especially the difficult ones for internal and external spinal canal tumors and intramedullary spinal cord tumors. Considering the stability of the spinal column, we have adopted the “opening and closing door” technique to restore the normal morphology and structure of the spinal canal, and to protect the basic stability of the spinal column. In order to minimize the damage to the stability of the spine, we even use minimally invasive half-plate surgery as much as possible, which does not damage the stability of the spine and eliminates the need for internal fixation, which simplifies the surgical process and saves the patient a great deal of money, but of course this is inevitably based on the application of microscopic technology and the locking hole approach technology. We have also done a lot of work in the treatment of skull base deformity, especially dentofacial deformity. Due to the deep location of the dentofacial process and the upward and backward displacement of the deformed dentofacial process to compress the medulla oblongata, it is very difficult to perform surgery, and the surgery faces great risks, so we abrade the dentofacial process through the mouth by skillful microscopic techniques, and then perform the cricoid-occipital fusion through the posterior approach with internal fixation techniques. In some cases, it is even possible to reset and internally fix the dentate process through the posterior approach, and dozens of cases have been completed, bringing new life to patients who had almost lost hope. Especially in cervical spondylosis and cervical disc herniation, the application of neurosurgical microscopic technology has added countless colors to such surgeries. In China, cervical spondylosis has always been the scope of orthopedic treatment. With the use of microscope and microtechnology, under the guidance of minimally invasive concept, the anterior cervical spine not only has a smaller surgical incision, but also has less pulling on the surrounding vital organs, and the structure of posterior margin of the vertebral body is more clearly revealed, and the pressure on the cervical cord is more gently harassed, but also the use of microscopic grinder makes the decompression of cervical cord more complete, and it is able to remove the diseased disc, thickened calcified disc, and other organs safely and thoroughly under the direct visualization. It can safely and thoroughly remove the diseased intervertebral discs, thickened and calcified ligaments as well as hyperplasia under direct visualization, which makes the treatment effect more perfect and the complications and risks brought by the surgery are significantly reduced. Needless to say, spine surgery is a cross-discipline, neurosurgery and orthopedics have their own strengths, and the relationship between the two disciplines should not be isolated, competitive, or even antagonistic, but should learn from each other, complement each other’s strengths, promote each other, and develop harmoniously. For neurosurgeons, should take a positive attitude to carry out spinal surgery work, but to carry out spinal surgery work must be modest to orthopedic surgeons to learn spinal fixation technology, must go through a rigorous spinal internal fixation technology training, do not blind arrogance, quick success. At present, the scale of spinal neurosurgery in China is still far behind the developed countries in Europe and the United States, China’s neurosurgeons should be in line with the idea of “all for the sake of the patient”, and orthopedic surgeons learn from each other to implement the scientific concept of minimally invasive, and give full play to the advantages of microscopic neurosurgical technology, and actively promote the development of neurosurgery of China’s spine and ultimately bring more help to the patients. This will bring more help to the patients.