1.What is spastic cerebral palsy? Cerebral palsy refers to central movement disorders and postural abnormalities caused by non-progressive brain injury or developmental defects during the early brain development of infants and children before and after birth. Cerebral palsy is divided into several subtypes, 75% of which are spastic cerebral palsy, mainly manifesting as spastic muscle tone in the limbs. The upper limbs show finger joint flexion, hand clenching, thumb inversion, wrist flexion, forearm rotation, elbow flexion and shoulder joint inversion. The lower extremities showed pointed feet, inward and outward turning of the feet, knee flexion or hyperextension, hip flexion, inward and internal rotation, thigh inversion, toe landing when walking, and scissor gait. The lower limbs are limited in separating movements, and it is difficult to support the weight of the lower limbs when the soles of the feet touch the ground. Spastic cerebral palsy can be treated surgically to relieve or eliminate the spasticity, thus improving or restoring motor function. However, there are many methods of surgical treatment, and it is especially important to choose the best timing and surgical approach. Many patients choose the method of orthopedic rehabilitation, but it will cause the deformity to recur within a short period of time after the surgery, which will have serious constraints on the rehabilitation effect because the spasticity still exists. 2.What is SPR surgery SPR is called selective posterior spinal nerve root dissection. Its surgical mechanism is as follows: due to the damage of the downstream inhibitory system of the brain in spastic cerebral palsy patients → resulting in weakened inhibition of motor neurons → increased sensitivity of muscle sensory stimulation → epidemic contraction of muscles, selective cutting of sensory afferent nerve fibers → preservation of other sensory nerve fibers → blocking the loop of spinal reflexes → release or The spasm of the limb is relieved. SPR is performed by intraoperative monitoring through multi-conductor electrophysiological techniques to determine the proportion of posterior spinal nerve roots to be resected, so that the extent and proportion of sensory nerves to be resected is scientific and objective. The patient’s muscle tone is adjusted comprehensively so that the muscle tone of spastic muscles is as close to normal as possible. The muscle spasm of cerebral palsy patients is not limited to a single muscle, but often manifests as spasm of multiple muscles or muscle groups. This surgery can achieve the effect of comprehensive adjustment of muscle tone, and can solve the pain of muscle spasm of patients in a long-term, stable and thorough way, providing the prerequisite for the maximum recovery of their motor function. Indications for surgery: 1.Simple spastic cerebral palsy with muscle strength above grade 3; 2.Patients with certain motor functions of trunk and limbs, abnormal gait and power deformity due to contracture only; 3.Spasticity involving the whole limb or bilaterally; 4.Severe spasticity and stiffness affecting daily life, care and rehabilitation training; 5.Normal or near normal intelligence, age above 3 years old, to facilitate postoperative The age of the patient is 3 years old or above to facilitate post-operative rehabilitation training. According to the statistics, SPR surgery has an effect on the higher centers and reduces their excitability. 20% of those with upper limb spasms have reduced upper limb spasms; 70~80% of those with epilepsy have reduced seizure frequency or reduced seizure control drugs; 34.2% of those with strabismus have reduced; 60% of those with salivation have reduced salivation and 25% of those with salivation have disappeared; 15% of those with speech dysarthria have improved pronunciation.