Spinal cord cavitation is initially numbness, then it starts to deform, perception gradually disappears, and at first it is possible to walk, then it becomes paralyzed in bed, certain parts of the body have broken due to years of being bedridden, and the whole body is thin and weak. How to cure? Surgical treatment is optional, such as laminectomy and decompression, spinal cord cavity and subarachnoid shunt, foramen magnum decompression, and fourth ventricle outlet correction. As the general conservative treatment is not able to slow down the further development of the disease. Due to the loss of the cushioning effect of cerebrospinal fluid at the cervico-occipital junction, inadvertent injury to the neck may cause serious consequences such as limb paralysis, respiratory arrest or even death. Surgery is therefore an important tool in the treatment of spinal cord cavities. Spinal cord cavitation is often a secondary manifestation of the associated primary disease, and spinal cord cavitation will disappear on its own after proper treatment of the primary disease. The surgical treatment of spinal cord cavitation can be divided into two parts: one part is to perform bony and membranous decompression of the craniocervical junction area to correct the deformity and prevent the progression or deterioration of the disease; the other part is cavity shunt surgery, i.e., cavity fistula or tube shunt to relieve the compression of the cavity on the spinal cord to relieve the symptoms or prevent the progression of the disease. Usually the first part is done for spinal cord cavitation with subungual herniation, and the second part is chosen according to the situation. Usually we have to first relieve the cause of the patient’s disease, and the first surgery usually does not work with a cavity shunt, as most patients will have the cavity disappear on its own after the cause is removed. The cavity bypass is used as a further solution to the patient’s disorder. At present, minimally invasive small incisions (about 4-6 cm in length) with minimally invasive instruments and small bone windows (2X3 cm in size) are used to treat subungual herniation of the cerebellum with spinal cavity with good results. Minimally invasive surgery is completely different from conventional major surgery. Minimally invasive surgery is performed with the assistance of microscope to complete various operations within the dura, such as separating the adhesions between the cerebellar tonsils and the brainstem and releasing the obstruction of the middle foramen of the fourth ventricle. The possibility of damaging the surrounding important structures during surgery is minimal, and it is even more rarely life-threatening. Cavernous shunt: Usually, the cavity is cut open at the site where the cavity is more obvious, so that it can be connected to the subarachnoid or thoracic cavity. A “T” tube is usually used to perform a cavity-thoracic shunt, which can maintain a certain potential gradient of cerebrospinal fluid and better complete the cavity shunt. This shunt can avoid the adhesion obstruction caused by the cavity-subarachnoid shunt, and thus the success rate of the operation is significantly improved. The current “minimally invasive, limited, and adequate decompression” surgical concept and individualized treatment can maximize the relief of the patient’s disease.