The treatment of primary and secondary tumors of the spine is still controversial. The aim of this study is to review our series in order to discuss the indications, the techniques and the results of the surgical treatment. 153 patients with spinal tumor (78 primary lesions and 75 metastases) have been treated from 1977 to 1995. The objectives of surgical treatment are mainly aimed at suppressing pain, restoring or maintaining neurological functions and stabilizing the spine. Transoral, transthoracic, thoracoabdominal, combined anterior and posterior approaches were used in a single surgical procedure or in two different stages. The most frequently used instrumentation was the Cotrel-Dubousset. Somatic reconstructive devices were implanted in 5 patients. The postoperative result was judged as excellent in 46 patients, good in 34, fair in 28 and poor in 18. On the whole, satisfactory results were obtained in 63.5% of cases whereas the outcome was unsatisfactory in 36.5% of subjects. In 46% of our cases, a good neurological recovery was observed even though it was short-lived because of recurrences (40%). Pain was reduced in all, except two patients. Local relapses were observed in 9% of treated patients, while 5% had lesions in other sites.