Surgery for severe spina bifida is more complex, such as spinal cord exstrophy, and children should be operated on as soon as possible after birth, while other types of spina bifida, such as spinal cord spondylolisthesis, are usually operated on at 2 to 3 months of age. Surgery for spina bifida is not as simple as one might think and requires a very high level of surgical skill. The main principles of surgery include removal of the eroded and necrotic tissue surrounding the spinal cord ectoplasm, return of the exposed spinal cord to the spinal canal cavity, removal of the lipoma, loosening of the spinal cord embolus (spinal cord embolus means that the lower end of the spinal cord is attached to the wall of the spinal canal), repair of the spinal canal, and repair of the subcutaneous tissue and skin at the site of the cleft. The most important role of spina bifida surgery is to alleviate disease progression and prevent the development of serious symptoms such as neurogenic bladder and lower limb paralysis, and also to address defecation dysfunction and lower limb dysfunction. Without surgery, it is highly likely that the above symptoms will soon appear, or even lifelong paralysis. If the surgery is handled well, the results will be very obvious and the complications will be less. However, due to the difficulty of the surgery itself, the skill level of the surgeon may vary, and when the surgeon’s professional knowledge and experience are not sufficient, some nerve and tissue damage may occur during the surgery, leading to postoperative complications. Especially once nerve damage is caused, it is often difficult to recover. This is one of the major reasons why many patients believe that the surgery is not effective. This is why spina bifida surgery requires a specialized physician to protect the nerves as much as possible during surgery and to address the disease on that basis. If nerve damage occurs, the likelihood of another surgical treatment is very low.