Patient: In April 2010, I found that my child had pain in his feet, and the pain was relieved by walking a bit during the day, but he could not even sleep well at night when he was in pain; he had to urinate for the first time at night. So on July 22, 2010 in Chongqing Southwest Hospital neurosurgery examination confirmed the diagnosis of lumbar 1-3 vertebral canal dermatomal cyst on July 22, 2010 in Chongqing Southwest Hospital neurosurgery lumbar 1-3 vertebral canal dermatomal cyst surgery, nearly 9 months the child foot bending does not pain, but currently can not fully control urination and defecation, (he knows there is urine, immediately go on, but can not control), in 2012 On July 19, 2012, he was examined and the cyst was found to have grown, and the child’s sense of urine control has deteriorated. At present, he can’t control his urine and stool completely and the cyst has grown. Li Jinliang, Department of Pediatric Surgery, Second Hospital of Shandong University: Intravertebral dermatomal cyst (probably in the spinal cord) and neurogenic dysfunction of urination and defecation need to be completely removed by surgery again, otherwise the cyst will eventually become completely incontinent and paralyze the lower limbs as it grows. Patient: An 8-year-old child who had surgery for a lumbar 1-3 spinal canal dermatomal cyst is currently unable to completely control his bowel movements. In October 2009, the child was found to have pain in his feet, which was occasionally relieved by walking a little during the day after the pain had risen, and was normal when it was not painful, but slightly more severe at night when it was painful and he could not sleep well. So on July 22, 2010 in Chongqing Southwest Hospital neurosurgery examination confirmed the diagnosis of lumbar 1-3 vertebral canal dermatomal cyst. On July 22, 2010 in Chongqing Southwest Hospital neurosurgery moved lumbar 1-3 vertebral canal cyst surgery, after surgery, although the ankle pain is not, but the current urine and stool can not be fully controlled, (he knows there is urine, immediately go on, but can not control), stool each time to solve less, in July 19, 2012 to do the examination, I send you the situation, please ask: (1) the child’s situation is the cyst recurrence? (1) Is the child’s condition a recurrence of cyst? (2) Is there any spinal cord injury, nerve injury, or nerve adhesion on the film? (3) Do you need a second surgery? Is there a spinal cord embolism on the film, and if so, is it necessary to cut the end filaments, will it damage the cauda equina nerve, and is the surgery risky? (4) If surgery is performed, will the child’s bowel movement be improved and will it affect the child’s movement? Li Jinliang, Department of Pediatric Surgery, Second Hospital of Shandong University: It is a recurrence. The film can only confirm the presence of terminal low spinal cord (spinal cord embolism) and cysts. Damage to the spinal cord and its nerve roots is not visible on the film, but is manifested by symptoms such as incontinence. Whenever spinal cord surgery is performed there are definitely spinal cord and nerve root adhesions, but they mostly do not cause problems. Whether the surgery or the original adhesions caused the spinal cord to be low is only observed intraoperatively. The damage to your child’s spinal cord and its nerve roots is mainly due to compression and invasion of the spinal cord and nerve roots by the growing cyst, supplemented by spinal cord embolism and adhesions to the spinal cord and its nerve roots. Another surgery is needed to try to remove the cyst completely and to cut the end filaments and separate the adhesions. Surgery is to remove the cyst that grows within the terminal segment of the spinal cord, which definitely has damage to the spinal cord and may also involve the nerve roots emanating from the end of the spinal cord (i.e., cauda equina), and the risks of surgery are high. Incontinence cannot be improved after surgery (because nerve cells, i.e., neurons and broken nerve fibers, in the spinal cord that have died under the microscope cannot be restored, and those that have not been damaged cannot be regenerated after birth (, being the only nonrenewable body Unlike other tissues and organs such as liver, skin, etc.), the doctor and patient currently have no better choice than to risk surgical removal (which will certainly cause either mild or severe spinal cord damage) or to wait for the cyst to grow and further compress the spinal cord causing more spinal cord damage until the lumbar segment (which governs the lower extremities) and the sacral segment of the spinal cord (which governs urination, defecation, perineum and genitalia) are completely paralyzed. Wait 1-2 years after spinal cord surgery for the damage to the spinal cord and its nerve roots to stop worsening and stabilize before considering therapeutic measures to improve bowel and urinary control.