Spinal column is the most common bone metastasis site of advanced malignant tumor, which can cause pathological fracture of vertebral body, spinal cord and nerve compression and pain, deformity and even paralysis, seriously affecting the quality of life of tumor patients. In the past, Tomita, Tokuhashi and other scores were mainly used to evaluate the prognosis of spinal metastasis and determine the treatment plan. With the deepening of the research on tumor biology, new therapeutic methods keep emerging and have achieved good therapeutic effects, and a new prognostic evaluation model and treatment decision-making framework for spinal metastatic tumors have emerged. At the same time, the minimally invasive surgical treatment, stereotactic radiotherapy and targeted therapy of spinal metastases have also made great progress.