Among the comprehensive treatment options for pediatric cerebral palsy, there is a surgical approach called selective spinal nerve rhizotomy, or SPR surgery. After surgery, it can significantly reduce the muscle tone of both lower limbs, and a significant percentage of children gain the ability to walk independently after surgery. 1. Spastic cerebral palsy has been treated for more than 100 years. In 1889, Sherrington began to use the method of spinal nerve posterior root severing to release the muscle spasms of deafferented cats. 1908, Foerster applied spinal nerve posterior root severing to treat the muscle spasms after cerebral palsy. At that time, the posterior roots of the spinal nerves from L2 to S2 were cut and L4 or L5 was preserved to maintain the muscle strength of the quadriceps. In 1978, Fasano devised a method of selective posterior spinal nerve root dissection for the treatment of spastic cerebral palsy of the lower extremities by applying electrical stimulation to the small bundles of spinal nerves and dissecting those with a low stimulation threshold, which greatly improved the treatment of spastic cerebral palsy. Subsequently, Peacock, a South African doctor, continued to improve and perfect the treatment of selective posterior spinal nerve root amputation on this basis, making it one of the surgical methods for clinical treatment of spastic cerebral palsy. In recent years, some scholars in China have also explored dorsal rhizotomy of spinal nerves in the lumbar and cervical segments, and certain efficacy has been achieved. However, because selective dorsal rhizotomy of the spinal nerve is more traumatic to the lumbar spine, especially to the cervical segment, the clinical application is greatly limited. Therefore, it is important to explore the reduction of r afferentation through nerve root or nerve trunk surgery. 2, the principle of surgery. Theoretically, it is believed that the brain belongs to the higher nerve center and acts as an inhibitor to the peripheral nerves, which are excitatory. In this way, the inhibition of the brain and the excitation of the peripheral nerves coordinate with each other, and the person can maintain normal muscle tone. In children with cerebral palsy, the inhibition of peripheral nerves is weakened due to brain damage, resulting in a relatively high excitability of peripheral nerves and high muscle tone, SPR surgery does not repair the damaged brain but artificially destroys part of the intact spinal nerve roots to match the damaged brain. 3. Based on the principle of SPR surgery, the timing of surgery is generally appropriate after the child is 6 years old. Because of the plasticity of the child’s brain before the age of 6, especially before the age of 3, the child’s cooperation with rehabilitation training is poor, at this time the best treatment method to develop the brain potential with massage techniques. After the age of 6, the child’s brain development is generally fixed, and there is little room for brain potential development and consolidation of the disease, so SPR surgery is an appropriate choice to reduce muscle tone at once. In addition, the order of SPR surgery and Achilles tendon lengthening: I believe that SPR surgery should be done first, after blocking the tension impulses that the brain continuously sends to the lower limbs, if the child’s Achilles tendon is still shortened, then it is appropriate to perform Achilles tendon lengthening. If the Achilles tendon lengthening is done first without blocking the tension impulses from the brain to the lower limb, the Achilles tendon may contract again and cause the recurrence of acromegaly, and a second surgery will be required. Besides, Achilles tendon lengthening is also a kind of destructive surgery, theoretically the smaller the damage to normal tissues the better. 4.The problem of SPR surgery risk. There are two kinds of risks. One is to cut off too much resulting in low muscle tone after surgery, muscle weakness and inability to stand, and excessive angle of the adductor muscle. One is to cut off too little resulting in unsatisfactory muscle tone decline. Once the above two situations occur, there is no possibility of secondary surgery to remedy the situation. Therefore, parents of children should make a thorough evaluation before surgery. Some of the children complained of back pain after surgery. 5. What kind of children will have good results after SPR surgery. First of all, SPR surgery is contraindicated in children with tardive dyskinesia because of their variable muscle tone. Spastic children with increased muscle tone in both lower extremities and scissor gait are the suitable group. In general, children with high muscle tone but not very poor muscle strength have a greater chance of gaining independent walking ability after a significant decrease in muscle tone after surgery. The poorer the muscle strength, the worse the postoperative outcome, because SPR surgery does not improve muscle strength, but on the contrary, it weakens some muscle strength. Therefore, it is possible that children with poor muscle strength may not be able to stand up after surgery. 6. The relationship between SPR surgery and rehabilitation training. Generally, after SPR surgery, there is no objection to the idea of long-term rehabilitation training. Some parents seek SPR surgery because of the long-term muscle tone cannot be lowered, expecting to see rapid results in the short term, and therefore have the idea of once and for all, and put too much hope on the surgery. In fact, the relationship between surgery and rehabilitation should be viewed in this way: the better the results of rehabilitation, the better the conditions for surgery and the better the results of surgery. As mentioned earlier, the prevailing view in the West is that there is no difference in the long-term outcome between rehabilitation and SPR surgery. Therefore, rehabilitation is indispensable at all times, whether surgery is done or not.