Surgery does not usually cause hydrocephalus. In rare cases, a sudden change in pressure in the spinal canal after surgery can lead to poor cerebrospinal fluid circulation causing hydrocephalus. In practice, however, hydrocephalus is mostly a symptom associated with spina bifida itself. Neurogenic hydrocephalus occurs primarily as a result of spinal cord embolism and, to a lesser extent, as a result of post-surgical nerve injury. If the hydrocephalus is mild, it can be observed postoperatively; if the hydrocephalus is severe, surgery for the hydrocephalus will be required. There are many ways to perform this type of surgery, and the 2 main types are as follows: ventriculo-abdominal shunt: A shunt is permanently placed in the body, which requires a lifelong tube and has many complications. Neuroendoscopic surgery: endoscopic fistulization of the floor of the third ventricle without tube placement. However, the technical requirements are high, and many hospitals do not have endoscopic equipment or specialist physicians.