Spasticity is a general term for a group of conditions characterized by spasmodic movement disorders and postural abnormalities, and limb spastic paralysis caused by craniocerebral trauma is very common. From May 2010 to December 2012, we performed microsurgery to treat 18 cases of limb spasticity after craniocerebral trauma, and according to the different conditions of the patients, we adopted corresponding selective peripheral neurectomy, and the recent results of the treatment were satisfactory. Now we report as follows: Data and Methods 1. General data: In this group, there were 18 cases of limb spasticity after craniocerebral trauma, 15 male and 3 female, with an average age of 20-60 years old, and an average of 33.2 years old, and a total of 26 surgeries were performed (some of the patients were operated more than one time), among which there were 8 cases of primary cerebral hepatic injuries, 9 cases of acute subdural hematomas and cerebral contusion, 1 case of diffuse axonal injury, and a disease duration of 24 months to 60 months, all of which were partial to the brain, and all of them were in a different condition. months to 60 months, all with hemiplegia. All of them were hemiplegic patients with stable spasticity, without severe muscle weakness, fixed contracture of tendons, irreversible bone and joint deformities, and the degree of spasticity of limbs was grade 3 or above according to the Ashworth score. 2. Surgical methods: selective tibial nerve, musculocutaneous nerve, median nerve, ulnar nerve micro-reduction: general anesthesia was used. A “bayonet” incision perpendicular to the N fossa and the N transverse stripe was made for the tibial nerve, and small vertical incisions were made at the junction of the middle and upper third of the medial aspect of the biceps muscle belly in the upper arm for the musculocutaneous nerve, median nerve, and ulnar nerve. Microscopic peripheral nerve trunks and their branches. According to the spasticity of the patient, the nerve branches innervating the corresponding muscles were revealed under the operating microscope, and the nerve branches were stimulated by the neuromuscular electrophysiological stimulator with a current of 0.05-0.1mA; the muscle contraction was observed to confirm and record the threshold value, and the nerve bundles were cut off in 1/3-2/3 according to the threshold value and the spasticity. Stimulate the nerve above and below the cut section to observe the muscle contraction and decide the proportion of the nerve to be partially cut. A 10-mm-long section of the severed nerve bundle is removed to prevent future nerve regeneration. Selective partial resection of the posterior root of the lumbosacral spinal nerve (SPR): general anesthesia is used. The L3-S1 vertebral plate was revealed, and a jumping, restrictive laminectomy was performed. After cutting the dura mater, the posterior roots of the unilateral L2, L3, L5 and S1 spinal nerves were found under the operating microscope, and each posterior root was divided into 4-8 bundles, and the threshold value of each posterior root bundle was confirmed by stimulation with a neuromuscular electrophysiological stimulator and recorded; the posterior root was partially cut off based on the high and low thresholds and spasticity, and the ratio of cutting off was as follows: 15 percent of the L2=30 percent, 20-35 percent of the L3, 20-35 percent of the L5, and 10 mm long section of L5 to prevent nerve regeneration in the future. L2 15%=30%, L3 20%-35%, L5 35%-50%, S1 40%-55%. A 10-mm-long section of the severed posterior rootlets was excised to prevent future nerve regeneration. According to the different spasticity status, selective partial excision was used, 18 cases of SPR in lumbosacral segment were unilateral; 8 cases of unilateral tibial nerve, musculocutaneous nerve, median nerve and ulnar nerve were microscopically reduced, all patients were firstly operated with SPR, and then the peripheral nerves were selected to be microscopically reduced according to the situation. All patients insisted on formal rehabilitation training after surgery, and all patients had immediate relief of limb spasticity immediately after surgery, with 98% relief rate and 95% improvement of quality of life in the early follow-up of patients. When spasticity has led to tendon contracture and osteoarticular deformity, the only surgical intervention that can be taken is orthopedic surgery to correct the deformity, which does not solve the spasticity fundamentally but only symptomatic treatment, and symptomatic recurrence is often inevitable. How to use surgical methods to fundamentally relieve spasticity, especially in the long-term spasticity caused by tendon contractures, bone and joint deformities before the implementation of surgery, so that the patient can maximize the benefits from the rehabilitation training, is a worthy of in-depth study of the subject. As early as the end of the 19th century Sherrington first elaborated the intrinsic connection between muscle tone and spasticity, laying the foundation for the application of neurosurgical methods to release spasticity. Neurosurgical treatment of spasticity is effected by interrupting the detrusor reflex circuits at different sites or by increasing the inhibitory function of spinal ā motor neurons in order to reduce the excitability of the affected muscles. The principles of treating spasticity are: comprehensive clinical evaluation, strict control of surgical indications, and providing conditions for rehabilitation by relieving spasticity and correcting deformities. At present, SPR and selective partial severance of peripheral nerves of the extremities are widely carried out in foreign countries, and the efficacy is accurate in long-term follow-up, but the neurosurgical treatment of spasticity has not been popularized in China. In recent years, there are more and more reports on the treatment of cerebral palsy spasticity in China, but there are few reports on the neurosurgical treatment of spasticity after craniocerebral trauma. Yu Yanbing et al. performed microscopic neurosurgery for the treatment of spasticity of non-cerebral palsy etiology in 356 cases, of which 90 cases were due to craniocerebral trauma, and the corresponding selective peripheral nerve partially cut off was used according to the different conditions of the cases, and all the patients were followed up for an average of 28 months, and the spasticity alleviation rate during the follow up period was 90.7%, and the improvement rate of motor function was 87.6%. The improvement rate of quality of life was 91.3%. It is believed that craniocerebral spinal cord injury and other central nervous system disorders involving the pyramidal tract can lead to spasticity through a mechanism similar to cerebral palsy, and selective peripheral partial neurectomy can relieve spasticity in patients with spasticity that is not cerebral palsy, and the efficacy of the operation is not inferior to that of cerebral palsy cases. This is conducive to the postoperative recovery of motor function through regular postoperative rehabilitation training. This group of patients also achieved good efficacy. Selection of surgery: SPR is suitable for patients with spasticity in multiple joints of lower limbs such as hip, knee, ankle or upper limbs such as shoulder, elbow, wrist, finger, etc. Improvement of motor function after spasticity is relieved after SPR can only be realized after 1 year, and spasticity recurrence is only possible, so long-term adherence to correct rehabilitation training is the key to ensure the efficacy of the surgery. Peripheral nerve micro-reduction surgery uses tibial nerve (for ankle spasms), sciatic nerve (for knee spasms), occlusive nerve (for hip adduction spasms), musculocutaneous nerve (for elbow spasms), median and ulnar nerves (for wrist and finger spasms), and brachial plexus nerves (for shoulder adduction spasms) to be cut off partially, which has the advantages of small incision, less bleeding, precise curative effect, and less complication, etc., and is especially suitable for patients with single and limited signs and symptoms. It is especially suitable for patients with single and limited signs and symptoms. The timing of surgery, because the craniocerebral trauma leading to more serious limb spasticity is mostly primary brainstem injury, cerebral contusion, diffuse axonal injury and other heavy injuries, so it is necessary to consider the surgical treatment of limb spasticity after the stabilization of the condition of the primary brain injury, which is the most basic prerequisite. It should be noted that the spasticity of these patients is unstable in the relatively early stage of the disease, and may progressively worsen, or gradually decrease due to the improvement of the brain injury or the early start of formal rehabilitation training. Therefore, before making a decision on surgery, another necessary prerequisite is that the spasticity is stabilized, because its severity directly determines the operator’s judgment on the proportion of the corresponding peripheral nerve dissection during the operation. of the judgment. In our case, the post-injury watchful waiting period was more than 2 years. In conclusion, early microsurgery to reduce the spasticity of hemiplegia caused by craniocerebral trauma after its condition is stabilized can provide a higher platform for rehabilitation training and significantly improve the quality of life of the patients.