The three steps of age in the surgical treatment of spina bifida: 1. Cystic spina bifida is detected after birth and is usually saved in time. The principle of treatment is surgical release of the nerve and dural sac reconstruction, along with reconstruction of the lumbosacral defect. In the case of children with cryptogenic spina bifida, parents are at a loss for what to do. Firstly, the presence of spinal cord embolism (imaging changes) and the type of pathological changes in the embolism should be confirmed by spinal cord MRI, and secondly, the timing of surgery should be chosen. Children with occult spina bifida often develop symptoms at the age of 3-8 years, and some by about 12 years, but problems can occur as early as 3-4 months, so the timing of surgery can be chosen in January after birth, and the risk increases significantly too early, because surgery for occult spina bifida is relatively cystic surgery is more complicated and the occurrence of injury increases; 2. For spina bifida in adolescents, in principle, as long as the cause is embolism (not due to surgical loss), active surgery should be performed, but surgery may not be the main purpose for the improvement of urination and defecation, the significance of which is to prevent the aggravation of foot and calf deformities; 3. For adult spina bifida with embolism syndrome, in principle, surgery should also be performed, but intraoperative strict neurophysiological testing, otherwise the benefit of surgery is not satisfactory to the physician and the patient. Individualized treatment should be advocated and cannot be generalized; some patients have greater surgical significance, while others require more detailed preoperative discussion and evaluation.