Intraspinal tumors refer to primary tumors and metastatic tumors growing in the spinal cord itself and in the tissue structures adjacent to the spinal cord (such as nerve roots, dura mater, adipose tissue in the spinal canal, blood vessels, etc.). According to the location of tumors in relation to the spinal cord and dura mater, intradural tumors are generally classified as intramedullary, extramedullary intradural and epidural. Extramedullary intradural tumors are the most common, followed by extradural tumors, and the least common are intradural tumors in the spinal cord. 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 neurofibroma, nerve sheath tumor, spinal meningioma, glioma, hemangioma and ventricular meningioma according to their histological origin, among which fibroma and sheath tumor account for 40%~55%, spinal meningioma accounts for about 25%~30%, and glioma, hemangioma and ventricular meningioma accounts for about 10%, which can be seen in various parts of the cervical, thoracic, lumbar and sacral areas. The effective treatment for intraspinal tumors is surgical resection. The goal of surgery is to completely remove the tumor, improve neurological function, stop the deterioration of neurological function, and improve motor and sensory function. Early diagnosis, early surgical resection, timely release of spinal cord compression, and minimizing secondary spinal cord injury during surgery are the keys to improving the cure rate. The choice of approach is a key issue in the treatment of complex intraspinal tumors. With the application of MRI imaging technology, the development of spinal and spinal cord microsurgery techniques and the renewal of instruments and equipment brought about by technological development, the surgical approach to intraspinal tumors has gradually changed, not only in terms of innovation of the traditional surgical approach, but also in terms of the emergence of minimally invasive spinal and spinal cord surgery. International minimally invasive spinal surgery was developed jointly by neurosurgery and orthopedics. Currently, in many developed countries and regions such as Europe, the United States, Japan, Korea, and Taiwan, neurosurgeons have adopted the concept of minimally invasive surgery, strategies for protection of the nerve and spinal cord during surgery, and microscopic techniques to play a leading role in the development of minimally invasive spine surgery due to the high-risk characteristics of cervical spondylosis, craniocervical junction disease, and spinal cord disease. Many minimally invasive surgical instruments were designed by neurosurgeons, such as the world’s first artificial disc and its successful application in cervical spine disease, which was designed by Dr. Vincent Bryan of Seattle Neurosurgery in 1990 and named Bryan Cervical Artificial Disc, which has been used until now. In the field of spinal cord surgery, in addition to endoscopic removal of herniated discs and endovascular interventions to treat endovascular malformations, minimally invasive techniques include percutaneous puncture vertebral scleroplasty and kyphoplasty, myeloscopy and spondyloscopy, stereotactic spine surgery (including navigation techniques), and stereotactic radiosurgery. Minimally invasive spine surgery techniques are derived from traditional spine surgery, but they are not a complete replacement for traditional spine surgery techniques. The general principles and operating techniques of traditional spine surgery are still applied to the practice of minimally invasive spine surgery techniques. To carry out minimally invasive techniques, it is important to first correctly understand the intent of minimally invasive techniques. Small incision operations are not the same as minimally invasive techniques. Simply narrowing the incision, inadequate exposure, increasing the strength of the pull hook, difficult to operate with ease, difficult to perfect hemostasis, increased tissue damage, rough and forced placement of fixation does not mean minimally invasive operation, and contrary to the intent of minimally invasive techniques, blindly pursuing tiny incisions is not minimally invasive techniques. Although with the configuration of high precision instruments, tiny incisions can achieve minimal damage, but the blind pursuit of tiny makes the anatomy unclear, the operation too rough, the steps are not in place, easy to accidentally injure important organs, the blind pursuit of tiny artificially causes the operation too difficult, prolongs the operation time, and even turns into traditional surgery in the middle of the operation, but becomes invasive or mega-invasive surgery, which fails to achieve the purpose of minimally invasive and destabilizes the internal environment is not minimally invasive technology trauma It is a kind of malignant stimulation to human body. Trauma can cause systemic reactions, and strong trauma reactions can lead to serious complications and even endanger life. In order to achieve the purpose of minimally invasive, excessive damage to normal tissues, prolonging the operation time, disrupting the stability of the internal environment of the body, causing other serious complications, and failing to achieve effective treatment. This kind of surgical operation is by no means minimally invasive. It is not minimally invasive because it is operated by hand and experience without the monitoring of imaging instruments. Due to the lack of equipment or fear of X-ray radiation damage, the surgeon’s blind and random operation is based on his clinical experience and sense of touch, and although the operation is completed and the tissue damage is minimal, the accuracy of the operation lacks objective testing and loses the meaning of minimally invasive techniques. Minimally invasive spine surgery techniques must be carried out to break the shackles of traditional concepts, familiar with the local and overall anatomy, master the performance and use of modern high-precision instruments, inherit the experience of traditional surgery operations, establish a highly responsible professional ethics, perform a rigorous, scientific and meticulous research style, and possess a hard-working and self-dedicated work ethic. Spinal microsurgery techniques. The use of the operating microscope or high magnification, magnification of the surgical field of view for surgical operations, through the smallest possible skin incision to perform “keyhole surgery”, so that spine surgery with minimal medical source of injury to implement the most effective treatment. The use of the surgical microscope allows the operator to clearly see small structures that are not visible to the naked eye, such as the arachnoid membrane and tumor, nerve roots and tumor, the boundary between tumor and cervical spinal cord, and especially the small vessels that supply or drain the blood flow to the tumor. With the help of surgical microscope, different spinal cord surgical approaches can be realized for microsurgical operation, which has the advantages of precision, clear anatomical levels, high resolution and small accidental injuries. However, it is characterized by a small surgical field of view, long operating time, and requires precise positioning of the surgical approach and skilled microsurgical techniques.