Over the vertebral plate defect to the vertebral canal outside the bulge The child is found after birth in the lumbosacral region, the back of the neck or the midline of the back with a soft mass, gradually increasing and in crying when the mass tension increases, lower limb deformity and incontinence, head enlargement and mental retardation, so many parents are very worried when they see a small tail in the child’s lumbosacral region, panic to seek medical help, often take a lot of detours. Symptoms of patients with cremasteric crepitus Cremasteric crepitus is a condition in which the cremasteric membrane and/or cremasteric nerve tissue in the spinal canal bulges outward into the spinal canal on the basis of cremasteric cleft, and the bulging tissue forms a localized sac-like bulge of varying size. It occurs in the lumbosacral region. Patients with cremasteric bulge need to be evaluated preoperatively for the degree of abnormal cremasteric function, the presence of other combined neural tube closure deformities, and the presence of cremasteric emboli to determine the surgical plan on a case-by-case basis. The goal of surgery is to repair the bulging defect, release the cremaster embolus, and preserve the structural and functional integrity of the nerve tissue. The surgery requires the return of the cremaster and nerve from the capsule to the spinal canal. The best time to operate for cremastero-crural bulge is within the first day or 48 hours after birth, and as late as 72 hours after birth. The goal of surgery in adulthood is to prevent progressive deterioration of cremasteric nerve function. For this patient, surgery is currently the only approach. The aim of surgery is also to prevent further deterioration of neurological function only. Pre-existing dysfunction may partially improve after surgery, but complete return to normal is difficult. The chance of serious complications related to surgery is low and safer. Symptoms and physical features of cremasteropathies First, take a medical history: ask the child whether a soft mass was found at birth in the lumbosacral, posterior cervical or dorsal midline, whether it gradually increased in size and tension during crying, whether there were deformities of the lower limbs and incontinence, and whether there was cranial enlargement and mental retardation. Next, a neurological examination was performed: whether there were motor deficits and deformities in the two lower limbs, incontinence of urine and stool, and saddle-shaped sensory deficits in the perineum. Note the size of the mass and the width of the base, the presence of cremaster and cauda equina shadows on fluoroscopy, whether the surface skin is normal or translucent membrane, and whether there are ulcers or perforated leaks. Then a crestal X-ray is performed: to understand the site and extent of the vertebral bone defect: X-ray examination can show the degree and extent of the developmental defect of the vertebral canal bone. MRI is performed:It shows the crestal medulla and nerve roots within the capsule and reveals other deformities that are often associated, such as crestal embolism, intradural (or (and) subcutaneous) lipomas, dermatomal cysts, or epidermoid cysts.