Spinal tumors are rare neoplasms comprising less than 10% of all central nervous system (CNS) tumors. The mainstay treatment for intradural spinal tumors remains surgery, after which some patients develop progressive deformity. It remains unclear how to best manage these patients, even though postoperative deformity has been recognized since the 1930s. Deformities following intradural tumor resection can manifest as scoliosis, kyphosis, lordosis, and even swan neck deformities. Not all patients develop deformity or require surgical correction, but the risk of this complication merits close follow-up. Multiple risk factors for postoperative deformity have been identified, and it is pivotal to keep such risk factors in mind, as it can guide surveillance and management. Patients differ in their risk factors at baseline, though, and as such, risk stratification is something that should be sought by the multidisciplinary team.