Spastic cerebral palsy, a form of cerebral palsy, is a disorder of movement and posture caused by non-progressive damage to the immature brain due to underdevelopment from various causes. The lesion affects the cone bundle system and manifests as increased muscle tone and limited limb movement. The upper extremities often show increased flexor tone, internalization of the shoulder, retraction of the scapular band, flexion of the elbow, flexion of the wrist, flexion of the thumb in the form of a clenched fist, and internalization of the thumb, clenched in the palm. The lower extremities often show increased thigh adductor tone, internal rotation of the hip joint, difficulty in thigh abduction, and plantar flexion of the ankle joint. This is often referred to as horseshoe clubfoot and scissor gait. When spastic cerebral palsy is detected early, it can be treated with active medical rehabilitation, and many children can get better results. However, as the child grows, after the age of 4 years, muscle contractures and other symptoms often appear, and it is difficult to achieve the desired effect with medication and rehabilitation alone. Therefore, it is necessary to resort to surgical treatment. The main purpose of surgical treatment for spastic cerebral palsy is to adjust the neural reflex arc, release the muscle spasm, balance the muscle strength, correct the bony deformity, adjust the negative gravity line of the limb, and improve the motor function. In layman’s terms, it means to release muscle spasm and correct deformity through surgery to provide conditions or new opportunities for rehabilitation treatment. There are three common surgical approaches to spastic cerebral palsy: neurological surgery, tendon and soft tissue surgery, and bone surgery. For patients with spastic cerebral palsy, early neurological surgery is mostly adopted. If early neurological surgery is performed and supplemented with regular rehabilitation, many subsequent muscular and bony surgeries may be avoided. Modern medicine believes that cerebral palsy is caused by the weakening of the inhibition of the lower unit nerve reflex arc after the brain has been damaged, and the abnormal activity of the lower unit reflex arc puts the muscles in a spastic state. Neurological surgery, whether it is posterior spinal nerve root amputation or partial peripheral nerve amputation, is to selectively and quantitatively interrupt this abnormally active lower unit reflex arc under electrophysiological supervision, thereby relieving the spasticity of the muscles. If neurological surgery is not performed, but only muscular or bony surgery is performed, the result is inevitable recurrence of spasticity. Neurosurgery is most effective in treating cerebral palsy patients with simple spasticity, followed by spasticity-based mixed cerebral palsy, and less effective in reversing spasticity, while tardive dyskinesia, ataxia, ankylosis, tremor, and hypotonia are not suitable for neurosurgical treatment. The best age for surgery is 4-6 years old, but it can be advanced to 3 years old for children with stable and severe spasticity.