Tethered cord syndrome (TCS) is a syndrome in which the spinal cord is stretched and the cones are lowered due to congenital or acquired factors, resulting in pathological changes such as ischemia, hypoxia, and degeneration of nerve tissues, and neurological damages such as sensory and motor dysfunction or deformity of the lower limbs, and dysfunction of urination and defecation are clinically observed. TCS can develop at any age, and its clinical manifestations vary depending on the type of pathology and age. The causes of spinal cord embolism include congenital spina bifida, intradural or extradural lipoma, spinal cord bulge, spinal cord adhesions after lumbosacral surgery, and longitudinal deformity of the spinal cord. The site of spinal cord embolism is mostly the spinal cord cone or the end of the terminal filament, but the cervical and thoracic segments of the spinal cord are being pulled due to various factors, and the symptoms of various nerve damages are also belong to the category of spinal cord embolism syndrome. The causes of spinal cord embolic syndrome can be categorized into primary and secondary. Primary TCS: In the early stage of embryonic development, the spinal cord and the spinal canal are equal in length, then the spinal column grows faster than the spinal cord, and because the spinal cord is fixed at the cephalic side, the spinal cord moves upward, and the spinal cord cone moves upward to the level of the L3-4 vertebrae at 20 w of embryonic development, and then at the level of the L3 vertebrae at 40 w of embryonic development, and the spinal cord end of the born babies is located at the level of the L1-2 vertebrae. After 3 months of life, the spinal cord rises to the adult level, i.e., the cones end at the L1 level. The cones of the spinal cord are thinned and shifted to the end filaments (less than 2 mm in diameter in adults). During the upward movement of the spinal cord, if there are pathological changes such as incomplete closure of the neural tube, intravertebral lipoma, spinal cord cone dermoid cyst or teratoma, longitudinal fissure of the spinal cord and other causes of spinal cord pulling, low cones and other pathological changes, the spinal cord end retraction is poor, and the cauda equina end filaments are adhered to and bound, resulting in dysplasia, which is known as the primary spinal embolism syndrome (PES). Secondary TCS:Mostly after lumbosacral spina bifida repair or spinal intradural surgery, the scar tissue in the area is adhered to the spinal cord and cauda equina, and the scar contraction leads to the spinal cord being pulled, also can be seen in the adherence formed after the local hemorrhage of arachnoiditis, which is called secondary spinal embolism syndrome.