1.What are the general symptoms of spinal cord tethering? In order generally appears dripping urine, dry stool, deformation of both feet or one foot, or even muscle atrophy of lower limbs and paralysis. If there is neurogenic bladder can lead to bladder enlargement, ureteral dilatation, hydronephrosis, and finally renal failure, uremia, and death. 2.What is the main purpose of spinal cord tethering surgery? To stop or delay the further development of the disease process, for example, patients with only urinary and fecal dysfunction can avoid muscle atrophy and paralysis of the lower limbs after surgery. 3.What is the best time to operate on spinal cord tethering? The earlier the surgery, the better it is to avoid the damage caused by the spinal cord traction due to the growth of the body. However, the younger the child is, the higher the surgical requirements are, so it is not a specialty that cannot perform the surgery. 4.Is it necessary to operate on adults who are no longer growing taller? Yes, it is necessary because although the body is no longer tall, it is often bent over, and bending over increases the distance, which pulls the spinal cord and aggravates the damage to the spinal cord. Therefore, surgery is still necessary to release the spinal cord tethering in adults. Among the cases we operated on, the oldest one was 56 years old and her condition improved after surgery. 5.Will there be a recurrence after surgery? The application of artificial spinal membrane and encouraging early activity can prevent recurrence. 6.How to deal with congenital spina bifida itself? If the spina bifida is small and does not affect the stability of the spine, it can be left untreated. If the bifida is large and the vertebral plate defect is large, which means that the spine is unstable and the protection strength of the spinal cord is poor, the spinal canal can be reconstructed with titanium plate. 7.Why is postoperative cerebrospinal fluid leakage the most common complication? In children with congenital spina bifida, various tissues (dura, bones, muscles) are missing at the surgical site, and cerebrospinal fluid tends to leak out along the tissue spaces after surgery, which can cause infection in the spinal canal in more serious cases. 8.Some children have had surgery before but the results are not good, can they have surgery again? Children who have undergone surgery before, but only removed the large lumbosacral pouch (i.e., bulging spinal capsule and lipoma) without dealing with spinal cord lesions in the spinal canal, are actually equivalent to “cosmetic” surgery of the lumbosacral region, which is ineffective or aggravated. For these patients, it is necessary to perform spinal cord tethering release surgery again to really achieve complete release and complete freeing of the spinal cord ends. 9.Why do patients have normal urine and stool before surgery, but have dry stools after surgery? Patients with spinal cord tethering seem to have “normal” urine and stool before surgery, not because the nerve function is normal, because the nerve is in the compensatory stage during the course of the disease, so that the bladder sphincter and the forced urinary muscle reach a state of equilibrium, which is normal for urination, while the surgery is to separate the nerve, in order to release the nerve adhesions, tethering as the ultimate purpose, it is inevitable to affect the nerve and break the equilibrium, which is normal for urination. This dysfunction will be improved with the gradual recovery of the nerve (3 weeks-3 months) and the re-establishment of the equilibrium state, and this process is reversible. In contrast, the urinary dysfunction eventually caused by non-surgery is not recoverable and is irreversible. The same holds true for stool performance. 10.Why do some infants and young children with surgery still have foot deformities after surgery? The fetus with spinal cord tethering has already been strained by the spinal cord during the long-term maternal gestation process and caused nerve damage, which was not manifested as foot deformation for a period of time after birth due to the imperfect development of muscle tissue in the lower limbs. After surgery, as the child grows up, the normal nerves have good nutritional support for the muscles they innervate and make them strong and powerful, while the nerves with loss of function have no nutritional support for the muscles they innervate and cause them to be weak and ineffective. This imbalance in muscle strength leads to deformation of the foot due to pulling by a strong group of muscles. This is manifested as clubfoot or hooked foot.