Timing of surgery for intramedullary tumors Some people think that surgery for intramedullary tumors will aggravate spinal cord injury and lead to postoperative neurological dysfunction, and advocate that intramedullary tumors with less serious symptoms should be observed and treated first, and then surgery should be considered when neurological function status progressively deteriorates. However, a large amount of clinical data show that the surgical effect of intramedullary tumors is closely related to the severity of preoperative symptoms. Patients with advanced intramedullary tumors often suffer from severe compression and damage of the spinal cord, and their limbs are close to paralysis or completely paralyzed, and surgery at this time increases the risk of further damage to the spinal cord, and postoperative effect is poor, and it is difficult to recover the paralyzed limbs. Therefore, most scholars believe that early diagnosis and timely surgery is the key to the success or failure of intramedullary tumor treatment, and the lighter the preoperative symptoms and signs, the better the postoperative recovery, and even the near-normal state can be achieved. Surgery is the most effective way to treat most intramedullary tumors. The extent of surgical removal of the tumor depends on the boundary between the tumor and the spinal cord. If the boundary is clear, most of the tumors are benign, and the application of modern microsurgical techniques can not only achieve total resection, but also low surgical disability rate, and often obtain satisfactory results. Almost all ventricular meningiomas, well-differentiated astrocytomas, and angioblastic reticulum tumors have a clear boundary with the spinal cord, and the operation should be aimed at total resection or subtotal resection. The approach of making a small incision in the spinal cord to obtain a small amount of tissue for biopsy should be avoided in order to avoid delaying treatment. For intramedullary malignant tumors, although major resection or partial resection within the tumor can relieve the condition and alleviate the symptoms. However, considering the poor prognosis of intramedullary malignant tumors, which are often combined with a high rate of disability after surgery, some people believe that in such cases, only a spinal cord incision should be made, and after obtaining a histological diagnosis, the surgery should be terminated. For intramedullary dermoid cysts and epidermoid cysts, it is difficult to completely strip the cyst wall from the spinal cord by surgery, therefore, total excision is not forced, even if a small amount of the cyst wall remains, and recurrence is rarely seen over a long period of time. Lipoma in the spinal cord is impossible to be completely excised, feasible intratumoral major resection, can also obtain a definite therapeutic effect. The outcome of surgery is related to the patients’ preoperative neurological function and the tumor site. Usually, most of the patients may have different degrees of sensory deficits after surgery, which may be related to the midline spinal cord incision, and the subjective symptoms are often inconsistent with the objective examination results. However, such postoperative sensory deficits may gradually improve. For patients with severe and prolonged preoperative neurologic dysfunction, postoperative recovery was poor and even further aggravated postoperatively, while patients with mild preoperative symptoms recovered quickly and well after surgery. It shows the importance of early diagnosis and early treatment.