Patients, especially children, with spinal cord tethered syndrome should be alert for clinical manifestations of dermal sinus tracts or subcutaneous masses. Tetheredcordsyndrome (TCS) is a syndrome in which the spinal cord or conus is stretched due to various congenital and acquired causes, resulting in a series of neurological dysfunctions and deformities. TCS is also known as hypospadias because the spinal cord is most often stretched in the lumbosacral medulla, causing the cones to be abnormally low. Congenital cutaneous sinus tracts (dorsaldermalsinusesofcongenitalorigin): These sinus tracts are due to the failure to separate the neural tube from the surface embedded skin. Sinus tracts are commonly found in the lumbosacral region, head, and chest; most of them present only as deep depressions, and true sinus tracts are rare; the skin at the sinus tract may be normal, hairy, or hemangioma, and may be accompanied by spina bifida; sinus tracts as an entrance can cause manifestations of meningitis, abscesses, and osteomyelitis, and dermatomal cysts caused by sinus tracts can cause compression symptoms. If the sinus tract causes central nervous system infection or compression symptoms, surgery should be performed. The diagnosis of dermatomal sinus tract is not difficult based on the typical history, clinical manifestations and ancillary tests. Since the early stage of dermal sinus tract is often asymptomatic or the development of symptoms is insidious, a few patients with acute onset cannot improve neurological dysfunction with treatment. Patients with sinus tracts should be actively diagnosed and treated to avoid aggravation of the disease leading to serious consequences. The diagnosis of dermatomal sinus tract can be based on the following clinical symptoms: 1. bladder and rectal dysfunction: bladder and rectal dysfunction often occur simultaneously. The former includes enuresis, urinary frequency, urgency, urinary incontinence and urinary retention, while the latter includes constipation or fecal incontinence. In children, enuresis or incontinence is most common. Based on bladder function measurements, they can be divided into spastic small bladder and hypotonic large bladder. The former is often combined with spastic gait, urinary frequency, urinary urgency, stress incontinence and constipation, which are manifestations of upper motor neuron damage; the latter is manifested by low-flow incontinence, increased residual urine volume and fecal incontinence, which are manifestations of lower motor neuron damage. 2, lumbosacral skin abnormalities: 90% of children have subcutaneous masses, 50% have skin sinus tracts, spinal membrane bulge, hemangioma and hirsutism. About 1/3 of the children have subcutaneous lipomas growing laterally and spinal membrane bulge on the other side. Subcutaneous masses in the lumbosacral region can be very large and attract parental attention because of aesthetic problems. Individual children may have a skin flab in the sacral area, forming a tail. The above skin changes are found in less than half of adults.