In infants with occult spina bifida, there are usually no other abnormalities except for pigmented nevi, small dimples in the skin and hair on the lower back. Therefore, the best time for surgery in children with occult spina bifida is 1-4 months after birth. With the use of micro-neurosurgical techniques, neurophysiological monitoring and ultrasonic suction knife, even children with complex lesions can be completely cured. This child had no abnormal symptoms on admission, but the spinal cord MRI showed a complex lesion. The child had a combination of a spinal cord cavity, a longitudinal spinal cord fracture, and a fatty thickening and shortening of the terminal filaments to form a spinal cord embolus. All of these lesions can eventually cause severe neurological damage to the child, resulting in incontinence, foot deformity, and even disability. Surgery is performed to deal with the spinal cord cavity, remove the bony separation between the longitudinal fissures of the spinal cord, and sever the lipomatous and thickened terminal filaments under neurostimulation. After removal of all spinal cord abnormalities, the dura is repaired with an artificial dural expansion or even a canaloplasty to avoid re-adhesion of the spinal cord to the surrounding area. With a tightly sutured dura, early postoperative movement of the child out of bed can further prevent adhesions from occurring.