The spinal cord is located in the spinal canal, and as people grow and develop, the spinal canal grows faster than the spinal cord, so the lower end of the spinal cord rises gradually in relation to the lower end of the spinal canal. Spinal cord tethering is a condition in which the lower end of the spinal cord cannot rise normally due to various reasons, making its position lower than normal. It is one of the main pathological mechanisms of various congenital developmental abnormalities leading to neurological symptoms, resulting in a series of clinical manifestations known as spinal cord tethering syndrome, also known as spinal cord tethering syndrome. Etiology: Various congenital developmental abnormalities of the spinal cord and spinal ends can lead to spinal cord tethering [1], such as occult spina bifida, spondylolisthesis, spinal cord spondylolisthesis, spinal cord end filament tension, lumbosacral intravertebral canal lipoma, congenital cysts, and latent hair sinus. In addition to the aforementioned congenital factors, postoperative adhesions in the lumbosacral spinal bulge can also lead to spinal cord reembolization. It is generally believed that spinal cord embolism causes blood circulation disorders at the end of the spinal cord, resulting in the corresponding neurological symptoms. Diagnosis and examination: Magnetic resonance imaging (MRI) is the main method to diagnose spinal cord embolism, which not only can clarify the presence of spinal cord embolism, but also can understand the coexistence of other pathological changes, such as lipoma, spinal cord longitudinal bifida, etc. X-ray can determine the presence of spina bifida. Urological ultrasound and urodynamics are performed to evaluate the extent of urinary tract involvement and spinal cord neurological impairment in conjunction with urinary and fecal function. Treatment: Surgical release of the embolus and removal of lesions such as lipomas. The spinal cord embolism is already organically altered by the time symptoms appear, and we cannot restore it to normal, but can only treat it with appropriate correction so that it does not progress. The symptoms of spinal cord embolism may be the result of destructive damage to the nervous system, which is usually irreparable, and treatment is simply to keep the damage from getting worse. Symptoms may also be the result of irritative or incomplete damage to the nervous system, when surgical treatment may have the dual effect of reducing symptoms and preventing progression. Therefore, the fundamental goal of surgical treatment of spinal cord tethering syndrome (spinal cord tethering syndrome) is to prevent the progression of the disease, and some patients may have improved motor and sensory function of the lower extremities, and even urinary and fecal function as a result. In general, the presence of dysfunction in the urinary and fecal regions is often indicative of a poor prognosis, and surgery usually does not improve dysfunction in the urinary and fecal regions or deformities of the lower extremities and feet, but may provide some improvement in pain and incomplete muscle strength loss. The deformities of the lower extremities and feet can be partially improved by orthopedic surgery. Therefore, for many patients with spinal cord embolism syndrome, especially in children, a combination of spinal cord spine surgery or neurosurgery, urology and orthopedic surgery is required. For patients with normal spinal cord embolism, including those with skin changes in the lumbosacral region and sensory and motor deficits in the lower extremities, early systematic examination, evaluation, and surgery are recommended; for patients who already have urinary and fecal dysfunction, surgery should be selected in the context of their general condition and relevant investigations, and most of these patients can and need surgery. Patients should be operated with the concept of minimally invasive surgery, insist on microsurgery, and cooperate with neurophysiological monitoring if necessary, in order to release the embolism as completely as possible, avoid nerve damage, reduce re-adhesion and embolism, and prevent postoperative wound complications. Postoperative patients are followed up and given the best possible guidance on the prevention and treatment of urinary tract dysfunction, rehabilitation of lower limb movement and sensation, and correction of lower limb deformities. We believe that focusing solely on embolization surgery and neglecting proper guidance for the continued treatment of these dysfunctions is detrimental to the patient. Symptoms of spinal cord embolism syndrome: constipation trauma sensory impairment ataxia myalgia scoliosis tendon reflex hyperactivity tension cough ulcer cleft palate clubfoot cysts urinary urgency urinary frequency incontinence skin nevus other symptoms weakness angioma enuresis