Mr. Ren, 47 years old, had numbness of the left upper limb and weakness of the right upper limb, his activity was not affected, but he could not walk steadily and had urinary and faecal problems. In a hospital in Chongqing City, a cervical enhancement magnetic resonance (MRI) was done, which showed an irregular mass in the cervical 1/2 level of the vertebral canal on the left side of the spinal canal through the left intervertebral foramen to the extravertebral canal, and the adjacent medulla oblongata was pressurized and degenerated, which was considered to be a tumorous lesion, and a tumor with a high probability of being neurogenic in nature. Because the tumor is located in the neck and high neck region, the surgical risk is very high, and the tumor is surrounded by many blood vessels and nerves, of which the thickest and most important blood vessel is the vertebral artery, and the thickest and most important nerves are the parasympathetic nerves and the cervical 1 and cervical 2 nerve roots, all of which are attached to the surface of the tumor. The difficulty of removing the tumor from such a complex area is imaginable. What is more dangerous is that the tumor is close to the medulla oblongata and the ventral side of the high cervical spinal cord, and the pulling, pushing, and separating operations when removing the tumor, if not careful, will hurt these important structures, which will result in serious consequences, such as high level paralysis or vegetative, or respiratory and cardiac arrest, and death in severe cases. Therefore, Director Yann suggests that in general, we neurosurgeons should use the most advanced surgical microscope for this kind of operation, and under the microscope, we should carefully separate the tumor step by step, until the tumor is completely resected. After the tumor was removed, it was revealed that the tumor bed was surrounded by medulla oblongata, spinal cord, bilateral vertebral arteries, and many nerve roots, and was preserved intact. When seeing the intracranial segment of bilateral vertebral arteries beating with the heartbeat, the neurosurgeon inhaled a deep breath of cold air, which represented the success of the operation, and the doctor’s hanging heart could finally be put down. Intravertebral canal tumor refers to a collective term for primary and metastatic tumors that grow in the spinal cord itself and in the tissue structures adjacent to the spinal cord within the spinal canal (e.g., nerve roots, dura mater, adipose tissue within the spinal canal, blood vessels, etc.). Clinically, according to the location of the tumor in relation to the spinal cord and dura mater, intradural, extramedullary intradural and epidural tumors are classified as intramedullary, extramedullary intradural and epidural tumors. Extramedullary intradural tumors are the most common, followed by epidural tumors, and intraspinal tumors are the least common. Intramedullary tumors account for 9% to 18%, extramedullary intradural tumors account for about 55%, epidural tumors account for about 25%, and dumbbell-shaped intradural tumors account for about 8.5%. Intradural tumors can be divided into neurofibromas, nerve sheath tumors, spinal meningiomas, gliomas, hemangiomas, and ventricular meningiomas according to their histological origin, of which fibromas and sheath tumors account for 40%~55%, spinal meningiomas account for 25%~30%, and gliomas, hemangiomas, ventricular meningiomas account for 10%, which can be seen in the cervical, thoracic, lumbar, and sacral regions. The effective treatment for intraspinal tumors is surgical resection. The goals of surgery are to completely remove the tumor, improve neurological function, stop neurological deterioration, and improve motor and sensory function. Early definitive diagnosis, early surgical resection, timely relief of spinal cord compression, and minimization of secondary spinal cord injury during surgery are the keys to improve the cure rate. Intravertebral canal tumors are complex, and the choice of approach is a key issue in treatment. With the application of MRI imaging technology, the development of spinal cord microsurgery technology and the renewal of instrumentation brought about by the development of science and technology, the surgical approach to intraspinal tumors has gradually changed, which not only manifests itself in the innovation of the traditional surgical approach, but also the emergence of minimally invasive spine and spinal cord surgery. International minimally invasive spinal surgery is jointly developed by neurosurgery and orthopedics. Currently, in many developed countries and regions such as Europe, the United States, Japan, South Korea, and Taiwan, neurosurgeons have adopted minimally invasive surgical concepts, intraoperative nerve and spinal cord protection strategies, and microscopic techniques to play a leading role in the development of minimally invasive spinal surgery due to the high-risk characteristics of cervical spondylosis, cranio-cervical junction disorders, and spinal cord disorders. This article provides the following review of the current traditional spinal cord surgical approaches and the characteristics of minimally invasive spinal cord surgery.