First of all the treatment and prognosis of adult spina bifida is different from the surgical treatment and prognosis of spina bifida disease in children. For children the vast majority of children develop normally after surgery as long as they are asymptomatic prior to the visit (1-3 months after birth). In adult patients with spina bifida, there are two types of cases: those who have no abnormal symptoms until they reach adulthood and are finally diagnosed with spina bifida when they develop back pain and leg weakness. In this case, surgery is absolutely appropriate, and the symptoms can be completely or partially relieved after surgery, especially some symptoms that are mainly back pain, which can be significantly relieved after surgery. For patients who did not have the conditions for surgery in the past or whose surgery was not complete, the symptoms are usually already obvious as they grow older and reach adulthood, including foot entropion, urinary and fecal incontinence, and individual patients even develop more serious complications such as hydronephrosis and renal insufficiency. In other words, there is already serious neurological impairment, and even after receiving the ideal spinal cord embolization surgery (neurological release surgery), it is usually impossible to completely reverse the impairment of urinary and fecal function, as well as the motor impairment of the lower legs and feet. So, does it still make sense for adults to have surgery? In fact, for most adults with spina bifida, surgery is absolutely necessary to prevent severe damage to nerve function, i.e., to avoid paralysis. Of course, for patients who are already unable to stand, there is no need to undergo surgery. In conclusion, spina bifida is a disease in which symptoms develop gradually with age, or may be unchanged at one time and significantly worse at another. The earlier the surgical intervention, the more neurological function is preserved and the less sequelae the disease develops. Surgery for adult spina bifida requires neurophysiological testing, and in lipoma-type cases also requires the assistance of an ultrasonic suction knife to be very safe, meaning that a reasonable procedure will not aggravate the patient’s condition. There are also individual cases where complete surgery may affect the blood flow to the end of the spinal cord because the nerve damage is too severe, or because the end of the spinal cord is significantly malformed, and if surgery is reluctantly performed, the symptoms may worsen. In such cases, it is necessary to have continuous neurophysiological monitoring during the surgery, and if there is a risk of neurological damage during the release of the spinal cord or nerves, we will stop the surgery to avoid causing medically induced neurological damage. In conclusion, the exact treatment plan for these cases requires a combination of MRI, ultrasound, neurophysiological examinations, and laboratory tests to be determined prior to surgery. For some special patients, it is also wise to terminate the surgery if there are abnormal changes in neurological function intraoperatively. These patients may not be able to avoid paralysis eventually, but the surgeon cannot cause early paralysis due to the surgery. The cost of surgery for adults is around $30,000: For adult patients with spina bifida who already have neurological impairment, there are treatment options to compensate for this lack of function, and subsequent treatment includes: for orthopedic limbs (orthopedic braces and surgery); to improve renal function, bladder function, and individual patients may consider receiving a sacral nerve stimulator to improve urination and defecation; through stem cell transplantation, hyperbaric oxygen, and Chinese medicine rehabilitation The patient may consider receiving sacral nerve stimulator to improve urination and defecation.