Patients with tethered cord syndrome, especially children, should be alerted to one clinical manifestation of the disease: hairy, abnormally pigmented skin in the lumbosacral region. Tethered cord syndrome (TCS) is a syndrome in which the spinal cord or conus is stretched due to various congenital and acquired causes, resulting in a series of neurological dysfunctions and deformities. TCS is also known as hypospadias because the spinal cord is mostly stretched in the lumbosacral medulla, causing the cone to be abnormally low. Tests needed for lumbosacral skin hirsutism and abnormal pigmentation: 1. MRI examination is the best and preferred test for diagnosing spinal cord embolism syndrome. It can not only detect the low spinal cord cone, but also clarify the cause of spinal cord embolism syndrome. 2.CT spinal canal imaging CT myelography can show the relationship between lipoma, spinal cord cone, cauda equina and dura mater, which can guide the development of surgical access. In addition, CT can show skeletal deformities, spina bifida, and tumors in the spinal canal. However, the sensitivity and reliability of CT diagnosis of spinal cord embolism syndrome is not as good as that of MRI, and CT spinal canalography is an invasive test; therefore, MRI diagnosis is sufficient for typical spinal cord embolism syndrome patients. Since MRI and CT have their own advantages and disadvantages, for complex spinal cord embolism syndrome or MRI diagnostic suspicion, combined application of MRI and CT spinal canal imaging is also required. 3.X-ray plain film examination Because MRI and CT spinal canalography have become the main diagnostic methods of this disease, X-ray plain film and conventional spinal canalography have been used less often. X-ray plain film examination is only used to understand whether there is scoliosis deformity and preoperative vertebral body positioning. Hanson et al. measured the electrophysiology of the sacral reflex in patients with spinal cord embolism syndrome and found that the shortening of the sacral reflex latency was one of the electrophysiological features of spinal cord embolism syndrome. The SSEPs of the posterior tibial nerve were found to be reduced or negative, and after re-surgical release, the SSEPs of the posterior tibial nerve increased, confirming the recovery of nerve function after end-filament release. 5.B ultrasound examination In patients <1 year old, because the posterior structure of the spinal canal is not fully mature and ossified, ultrasound can show the spinal cord cone, and can determine whether there is re-embolization after surgery according to the pulsation of the spinal cord. 6.Bladder function examination includes intravesical pressure measurement, cystoscopy and urethral sphincter electromyography. Patients with spinal cord embolism syndrome may have abnormalities such as sphincter-uretic muscle ataxia, increased (spasticity) or decreased (hypotonicity) intravesical pressure and changes in bladder residual urine volume. Preoperative and postoperative bladder function tests are useful to determine the efficacy of the procedure.