Spinal cavities are serious intraspinal neurological abnormalities that often occur secondary to fluid collection and barrel-like tandem changes in the central canal of the spinal cord, expanding up and down. It occurs in the cervical cord and upper thoracic spinal cord. Spinal cord cavities are not caused by scoliosis; rather, scoliosis is a specific clinical manifestation of spinal cord cavities, and spinal cord cavities and scoliosis can be combined. Scoliosis correction itself is a high-risk surgery, and when scoliosis is combined with spinal cord cavitation, the surgery is prone to complications of spinal cord and nerve injury increasing the difficulty and risk of scoliosis correction. The choice of separate or combined surgery after proper clinical evaluation of scoliosis and spinal cord cavity is of great significance. Current scholars agree that scoliosis progressing to severe and with indications for surgical orthopedics, patients with no obvious preoperative neurological injury symptoms can often achieve safe and satisfactory results with direct together posterior spinal deformity orthopedics without neurosurgical prophylactic surgery to deal with spinal cavities. If a spinal cord cavity with hypotonia and asymmetric limb development has developed, there is a great potential for neurological complications if scoliosis orthopedic surgery is performed directly without treatment of the accompanying deformity. The presence of other neurological deformities: spinal cord embolism, chiar deformity, etc., should be further defined before orthopedic surgery in scoliosis with spinal cord hollowing, which requires a collaborative assessment by a team of neurosurgeons and neurological monitoring throughout the orthopedic procedure.