Spinal cord tethering is not a trivial matter, and families are often very worried and would like to have surgery as soon as possible. However, surgery should not be done early, but requires a comprehensive assessment of the child’s condition, physical status, development and feeding before deciding when to operate. The purpose of surgery is to loosen the tethered spinal cord and, in the case of lipoma or spina bifida, to remove the lipoma, repair the spina bifida, and repair the skin of the lumbosacral region in order to prevent the child’s growth and development from being restricted, resulting in urinary and fecal dysfunction or deformities of the lower extremities. However, since surgery is also traumatic, the child must be in good physical condition to withstand the surgery and recover better and faster afterwards. If the spinal cord embolism is found at birth, but the child is still breastfeeding and is in poor health, or if the fetus has a spinal cord embolism in the mother’s womb, resulting in poor overall development, it is not suitable for immediate surgery. Because the child cannot be breastfed easily after surgery (the surgical incision is usually in the back), and children who have not been artificially fed before cannot get used to artificial feeding immediately after surgery, the child’s nutritional status and development are not up to standard, and it is difficult to recover from the surgical wound and the torn nerves. If the child is found to have spinal cord embolism at birth, but is in good physical condition and can withstand the trauma of the surgery and can adapt to artificial feeding, the surgery can usually be performed as early as 4 to 6 months. However, if the child is not in good physical condition, then the child should be fed and cared for to become stronger before surgery. In fact, there are no special rules for the time of surgery, generally 6 to 12 months or even before 2 years old.