The purpose of the prosthetic reconstruction of vertebral body after excision of malignant spine tumors is to provide the immediate and long term stability. The authors have experienced eight cases of prosthetic replacement with a titanium mesh cylinder and additional instrumentation in malignant spine tumors with neurologic deficit. There were three cervical, three thoracic and two lumbar lesions. Among them, five cases were instrumented by combined anterior and posterior procedures at one stage. Postoperatively, all cases showed excellent immediate stability. Ambulation was started within one week with minimal or no external support. Neurologic deficit observed in 7 cases were improved in all but one complete paraplegia. Major complications such as loss of fixation, recurrence or progression of deformity, and neurologic deterioration were not observed. Five patients could return to their previous occupation. Five patients with autogenous bone graft in the cylinder showed solid incorporation of prosthesis into the host bone. It is concluded that a titanium mesh cylinder replacement of vertebral defect after excision of the malignant spine tumors provides adequate immediate as well as long term stability when combined with bone graft.