Alin was discharged from the hospital with a few moments of hope and a few moments of helplessness. Alin is a young, strong, scientific and technical worker who is at the peak of his career. In a short period of 7 months, it went from pain and weakness in the lower limbs to difficulty in urination and defecation. The symptoms were getting worse, but the patient could never be clarified. After seeking medical help from many sources, the diagnosis of dural arteriovenous fistula was confirmed only 4 months after the abnormalities were found in the thoracic spine MRI. Li Guilin, Department of Neurosurgery, Xuanwu Hospital, Capital Medical University The dural arteriovenous fistula itself is a benign lesion in which the arterial blood supplying the dura regurgitates into the venous system of the spinal cord through an abnormal vessel, resulting in impaired circulation in the spinal cord itself, difficult blood return, and venous hypertension, which in turn leads to spinal cord edema and early manifestations of limb weakness and urinary and fecal disorders. If detected early, the treatment of dural arteriovenous fistula is relatively simple, as long as spinal angiography reveals the location of the arteriovenous fistula and surgical electrocoagulation cuts off the abnormal vessels. Postoperative anticoagulation is routinely performed for 6 months. However, because the incidence of the disease is low and it is a rare disease that is not recognized by most physicians, these patients are often seen late, and irreversible degeneration of the spinal cord has already occurred. Even when surgery is performed, recovery is slow or even difficult. This results in irreversible spinal cord injuries that can only be recovered with prolonged rehabilitation, although surgery removes the cause of the disease. In fact, this makes the treatment more difficult, prolongs the patient’s treatment time and increases the cost. The prognosis can only be observed, and the recovery of neurological function may take more than 18 months, even if it is no longer recoverable. Therefore, it is important to consider this disease in middle-aged and elderly people who have unexplained weakness of the lower limbs, urinary and fecal disorders, and unexplained spinal cord edema on MRI scan. MRI shows spinal cord edema and vascular flow void spinal angiography shows abnormal tortuous vessels