Abstract: Objective:To report the outcome of a new surgical strategy for metastatic spinal tumors and to discuss the characteristics and feasibility of this strategy. Methods: From January1996to December 2006, 249 patients with spinal me-tastasis underwent surgical treatment in the Department of Orthopedics and Traumatology-Spine Surgery of Ospedale Mag -giore, Bologna. There were 152 men and 97women. The average age was 57years. A new surgical strategy was exam-ined in this study. According to this strategy, feasibility judgments were based on the anesthetic evaluation. Patients with lower potential risk for surgery were judged to be operable, whereas those with high potential risk for surgery were judged to be inoperable. Reversible neurological deficit, pathological fracture , intractable pain and insensitivity to the adjunctive therapies were all considered when making the judgment. The surgeries included 3 main procedures: palliative surgery, cu-rettage surgery and en bloc surgery. Results: One patient died during the procedure and six patients died within1 month af -ter the procedure. Among the patients, 91.7% had pain that was relieved and 88.4% had neurological functions improve im-mediately after the operation. There were215 patients who were followed up with a mean time of 20.4 months and the me-dian survival duration was 20.9 ± 2.7 months. Among the patients followed up, 84.8% achieved local control.Conclusion: The main purpose of surgical management of spinal metastases is to improve the quality of life. It was found that reason-able surgeries can significantly improve the survival time and quality of life. The preoperative anesthetic evaluation is criti-cal for improved safety. However, the mathematic scoring systems in use are not appropriate to use for determining strate-gy for spinal metastasis management. The present individualized and flexible strategy, which not only takes advantage of the surgeries but also emphasizes the effects of the adjunctive therapies, is more scientific and reasonable so good surgi -cal outcomes can be achieved if this plan is used.