In developed countries, symptomatic metastatic spine disease is nearly twice as common as traumatic spinal cord injury. Patients who present with a spine tumor should be evaluated to rapidly establish a diagnosis. The primary indications for surgery are the presence of a neurologic deficit and spinal instability. Level I evidence supports surgical intervention in selected patients. This guide reviews the surgical technique for removing a metastatic tumor of the spine and decompression of the spinal cord.Quick Tips