Spina bifida is a congenital malformation of the spine, also known as spina bifida, and spinal closure insufficiency. It is mainly due to impaired development of the neural tube when the embryo is about 26 days old during maternal development and is now mostly thought to be related to folic acid deficiency in early pregnancy. The basic pathology of spina bifida is the absence of the spinal processes and vertebral plates to varying degrees, resulting in incomplete closure of the spinal canal, with the contents of the spinal canal directly adjacent to or even protruding outside the spinal canal. The lesion may involve one or more vertebrae and is often associated with deformities of other systems. Spina bifida is most often seen in the lumbosacral region, followed by the cervical segment, and less frequently in other areas. Surface recognition of spina bifida 1. Local skin manifestations: bulging or depressed skin in the lumbosacral region, possibly accompanied by discharge or infection; hirsutism; bulging large masses, etc. Often family members find a large lumbosacral skin bump within the first few months of a child’s life, which may actually be a lipoma and spinal cord spondylolisthesis, or a small depression that sometimes secretes some oil-like material, or even sometimes the child looks like a small tail has grown. This is the earliest and most important reason for patients to visit the clinic, and it is also the most important skin change of spina bifida that the child’s family should be aware of. 2, lower limb dysfunction: including lower limb and perineal sensory disorders, such as sensory numbness in the foot, serious burns or cuts still do not know the pain; lower limb, especially the foot and ankle motor dysfunction, such as foot drop, walking toe dragging the ground; lower limb foot and ankle deformity, such as horseshoe foot, etc.. In pediatric patients families often find that one leg has no strength, or the ability to walk is significantly delayed backwards, and one foot cannot be lifted significantly. By the time patients with motor dysfunction appear, it means that the spinal cord function is obviously damaged and the best time for surgery has been missed. 3, urinary and fecal dysfunction: common for constipation and urinary incontinence. Urinary abnormalities are caused by various pathological changes in spina bifida leading to neurogenic bladder, which in severe cases causes ureteropelvic effusion in late stages and finally leads to renal failure. This symptom symptom is often not generally noticed by the family because the child is young and is not recognized until he or she is older. Pediatric bedwetting and bowel difficulties are the most painful and survival-threatening lesions felt by the patient’s family. Urinary and fecal disorders make it difficult for patients to integrate into social activities, such as school and work. 4. Other manifestations: pain in the lower back, buttocks and lower limbs, etc. Lessons learned and advice for families: 1, spina bifida should be treated early, when the child grows up is the day the condition worsens. The treatment of this disease must not be delayed, at present, large general hospitals are able to complete pediatric surgery we have completed 1 month after the birth of the baby. We have performed surgeries on infants one month after birth, and not even a momentary delay has led to a lifetime of misfortune for the child. We always call for early treatment of this disease is the key. 2, urinary and faecal problems are the greatest pain of the patient’s family, do not avoid, to face and treat correctly, in the early stages of the disease through surgical treatment and correct training, the patient can recover, but the patient’s family and the patient must have a certain degree of expertise and full patience. And you can not rush, see the ability to solve the complete treatment of urinary and faecal advertisements, immediately go to treatment, the consequences are often lost money and not treated well. What I am telling you is that if spina bifida develops to a certain severity, there is no good treatment available in the world of academia. Therefore, I advise patients’ families to receive proper treatment and knowledge of disease rehabilitation. In summary, children with spina bifida combined with spinal cord tethering are generally asymptomatic as children, but as the body develops, the tethered spinal cord is stretched, resulting in the development of appropriate symptoms. Studies have shown that only about 45% of patients recover from motor dysfunction, such as weakness and numbness of the limbs, and only 12% of patients recover from urinary incontinence once it occurs. Therefore, once spinal cord tethering is detected, it should be treated surgically regardless of the presence or absence of symptoms. We are increasing the popularization and dissemination of clinical knowledge in this area, so that the families of patients recognize at birth that the posterior back masses, vascular nevi, skin depressions and hairiness are not the surface of the phenomenon and that there may be congenital malformations of the spine and spinal cord in the spinal canal. Early examination and surgery should be performed nearly as early as possible. Do not rush into surgery after the appearance of obvious symptoms, which may be regretted for the rest of your life. With the significant advances in modern anesthesia and neurocritical care, the age of the patient is now not an issue that limits surgery. We have performed this type of surgery many times on children under 3 months of age with excellent results. The ultimate goal of our surgery is to make the child grow up healthy and better integrated into society as a useful member of society when he or she grows up, after our efforts.