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目的 探讨采用选择性腰骶神经后根切断术(LUMBAR－SACRALSELECTIVE POSTERIORRHIZOTOMY,L－SSPR) 治疗脑瘫下肢痉挛时,部分患者出现上肢痉挛缓解,斜视、流涎好转及发音变清晰等现象发生的机制.方法 采用体感诱发电位(SOMATOSENSORY EVOKED POTENTIAL,SSEP), 感觉神经传导速度(SENSORYCONDUCTION VELOCITY,SCV)及运动神经传导速度(MOTORCONDUCTION VELOCITY,MCV)等电生理检查方法并结合临床,对517 例偏瘫型、三肢瘫型、四肢瘫型及双重偏瘫型脑瘫患者,在实施L－ SSPR术前及术后分别测定.结果 发现有153 例(29.59％) 患者除下肢痉挛缓解外,出现手与上肢痉挛有部分缓解,斜视、流涎好转及发音变清晰.并有167(32.30％)例患者出现SSEP潜伏期延长等改变.结论 对SPR解除痉挛的机制提出新的推测,即在γ－ 环路的基础上,还存在“外周－ 皮层－ 外周”的大环路.“,”Objective To analyze the reason of the clinical improvement of spasticity of upper limbs and amelioration of strabismus, slobbering and cacophonia after the lumbar-sacral selective posterior rhizotomy(L-S SPR). Methods 517 cases of cerebral palsy, operated upon with lumbar-sacral selective posterior rhizotomy, were studied. Electrophysiological examination such as somatosensory evoked potential (SSEP), sensory conduction velocity and motor conduction velocity were used pre and postoperatively to detect the mechanism of this phenomenon. Results 153 (29.59%) cases were found having partial amelioration of spasm of upper limbs in addition to the release from the spasticity of lower limbs. The electrophysiological results show the elongation of potential of SSEP among 167(32.30%) cases and are closely related with the clinical findings. Conclusion A new hypothesis is proposed about the mechanism of selective posterior rhizotomy(SPR). There is possibly a peripheral cortex peripheral tract which manages tonus of the extremity in addition to the γ-tract.