The authors' group has developed a new surgical technique of spondylectomy (vertebrectomy) called "total en bloc spondylectomy" (TES). This technique is different from spondylectomy in that it involves en bloc removal of the lesion, that is, removal of the whole vertebra, body and lamina, as one compartment. The surgical technique of TES has been remarkably improved based on adequate knowledge and consideration of the surgical anatomy, physiology, and biomechanics of the spine and spinal cord. Review of the developmental process of this operation leads to recognition of the tips, pitfalls, and solutions.