Spina bifida is one of the most common congenital malformations of the spine, also known as spinal neural tube closure insufficiency, spinal neural tube defects, with an incidence of up to 1 in 1000 births, including up to 4.7 in 1000 births in northern China. The most common form of spina bifida is absence of the spinous process and vertebral plates, with the spinal canal opening dorsally and the deformity affecting one or more vertebrae, with the lumbar spinal canal being the most common and a few occurring in the cervical or thoracic spine. Spina bifida is divided into recessive spina bifida and dominant (cystic) spina bifida. Among them, dominant spina bifida is subdivided into spina bifida, spinal cord spina bifida and spinal cord bulge. Most patients with spina bifida and spinal cord spondylolisthesis have varying degrees of tethered spinal cord syndrome (TCS), a syndrome in which spina bifida is combined with abnormal spinal cord development during embryonic life, local scar adhesions, and thick and short terminal filaments, causing the spinal cord to be fixed at the site of the lesion and unable to rise with the growth of the spine, causing the spinal cord, cauda equina, and terminal filaments to be stretched, resulting in bilateral lower limb and bowel dysfunction. The vast majority of patients with occult spina bifida do not show clinical symptoms throughout their lives, but a few patients have varying degrees of urinary incontinence and enuresis. The clinical manifestations of spondylolisthesis and spinal cord spondylolisthesis are divided into four areas: 1. Local mass: At birth, a cystic mass is seen in the midline of the back in the cervical, thoracic and lumbosacral regions, varying in size. The mass is round or oval in shape, with a wide base in most cases and a band in a few cases. The surface skin was normal or sometimes scarred and thin. In cases of previous rupture, the surface is granulomatous or infected. If the mass has been ruptured, there is leakage of cerebrospinal fluid from the surface of the mass. The mass may increase in size when the infant cries, and when the mass is compressed, the fontanelle bulges, showing that the bulging mass communicates with the subarachnoid space. Spinal bulge and spinal cord spinal bulge combined with lipoma, the appearance of the fat mass, its deep surface for the spinal cord bulging sac. 2, neurological damage symptoms: simple spinal bulge, can be no neurological symptoms. Spinal bulge and spinal cord terminal development deformity, deformation, the formation of spinal cord cavity, the symptoms are more serious, with varying degrees of bilateral lower limb dysfunction and even paralysis and urinary and fecal incontinence. Urinary symptoms are a manifestation of nerve damage. The spinal cord tethering syndrome worsens with age and height as the spinal cord bulge itself constitutes the spinal cord tethering. Spinal cord outgrowth usually shows more severe neurological symptoms, also depends on the degree of spinal cord deformity. 3, the bulging capsule is prone to break down and infection, leading to meningitis: occult spina bifida, if accompanied by episodic sinus tracts, can also cause recurrent symptoms of meningitis. 4, other symptoms: a few spinal bulge to the thorax, abdomen, pelvic protrusion, the emergence of masses and compression of visceral symptoms. A part of the combined hydrocephalus and other malformations, the corresponding symptoms appear. The clinical manifestations of spinal cord tethering syndrome are divided into three types: mild, moderate and severe, depending on the severity of spinal cord tethering and the location of the tether. Patients with mild type have weak muscle strength of the lower limbs, mild muscle atrophy, numbness, urine loss, and sometimes low back pain or leg pain. Mostly one lower limb is involved, but sometimes both lower limbs experience muscle weakness at the same time. Physical examination shows symptoms of peripheral nerve damage, low muscle tone, flaccid mild hypotonia, and hypoesthesia of the lower limbs and perineum. In moderate patients, the above mentioned motor and sensory impairment is more obvious, scoliosis, habitual hip dislocation, high arch, foot inversion and valgus deformity, and urinary and fecal incontinence are seen. In severe cases, the lower extremities are obviously hypotonic or even paralyzed, and the sensation is obviously reduced or lost, often complicated by neurotrophic changes, coldness and numbness of the distal lower extremities, ulcers in the lower extremities and sacrococcygeal area, and sometimes complete paralysis and incontinence. In children with spina bifida and spinal cord spondylolisthesis, the dysfunction of the lower limbs may increase with age and height and even lead to paralysis. Urinary symptoms mainly manifest as urinary incontinence and difficulty in urination, leading to recurrent urinary tract infections, long-term abdominal pressure urination causes hydronephrosis, renal insufficiency, serious cases can cause uremia life-threatening. It is often accompanied by constipation and fecal incontinence. Treatment Congenital spina bifida, spinal cord spinal membrane expansion caused by incontinence has been the world’s medical problems. Spinal cord spondylolisthesis repair or spinal cord tethering release after birth can improve the function of the lower limbs to varying degrees and delay further damage to the lower limbs, but the improvement of urinary and fecal symptoms is not satisfactory in some patients after surgery. For urinary and fecal incontinence, traditional treatment methods are basically symptomatic, such as indwelling urinary catheter, suprapubic cystostomy, intermittent self-catheterization, and bladder enlargement, etc. None of them can reconstruct the innervation of the bladder, and it is difficult to achieve self-controlled urination. The artificial body nerve-visceral nerve reflex arc (artificial reflex arc) has better solved the neurogenic bladder and urinary and fecal incontinence caused by patients with spina bifida and spinal cord spondylolisthesis by reconstructing the local innervation and central control of the bladder and rectum. The basic principle of the artificial reflex arc is that the distal end of the 1/2-1/4 branch somatic nerve motor fibers are anastomosed with the proximal end of the sacral nerve efferent fibers controlling the bladder and urethral sphincter, and the somatic nerve motor fibers can regenerate and replace the visceral preganglionic fibers, forming an artificial ‘skin-spinal cord central-Bladder’ reflex arc. Experimental studies in animals have shown that the somatic nerve can regenerate and replace the visceral preganglionic fibers to form an artificial reflex arc, the hybridized regenerated nerve fibers have a unique morphological structure, and there is normal neurotransmitter production and transport in the artificial reflex arc; the nerve impulses generated by somatic nerve motor neurons can follow the artificial reflex arc pathway to cause the urinary reflex in the bladder.