In February 2024, our hospital admitted a patient with primary germinoma growing on the cauda equina nerve and presenting severe neurological symptoms. X-ray, CT and MRI examinations revealed abnormal masses in the dural membrane of the patient's L2-3 spinal canal and complete invasion of the spinal canal. The patient underwent L2/3 right half laminectomy, spinal canal decompression and posterior lateral bone graft fusion and internal fixation +L3/4 total laminectomy, spinal canal decompression and discectomy, intervertebral bone graft fusion and internal fixation + excision of lumbar vertebral canal space occupying lesions. The tumor was completely removed during the operation, and the symptoms of nerve compression were gradually relieved and disappeared after surgery. To further deepen the understanding of this kind of disease, the treatment ideas were summarized and the literature was reviewed.