Abstract： Objective:To analyze the efficacy and complications of selective posterior rhizotomy (SPR) combined with replacement laminoplasty (RL) for the treatment of spastic cerebral palsy (SCP).Methods:The clinical data of 785 children with SCP who underwent SPR+ RL at the Department of Functional Neurosurgery of Beijing Children′s Hospital, Capital Medical University from September 2015 to June 2020 were retrospectively analyzed. Postoperative rehabilitation was routinely administered. Follow-up was performed from 6 months to 3 years after surgery. Efficacy evaluation criteria were gross motor function measure (GMFM) and modified Ashworth spasticity scale (MAS). Postoperative complications were summarized.Results:The spasticity and limb motor function of 785 children were improved to varying degrees after operation. The GMFM scores at preoperative and last follow-up were 34.9±5.2 and 58.9±8.0 respectively, and the MAS scores were 4.8±0.4 and 2.9±0.5 respectively, and the differences were statistically significant (both P<0.05). Short-term postoperative complications included low-grade fever (3.18%, 25/785), moderate to high fever (4.08%, 32/785), headache (1.91%, 15/785), and acute urinary retention (0.38%, 3/785), abdominal distension or difficulty in defecation (4.08%, 32/785), poor healing of superficial incision (3.18%, 25/785), deep incision infection (1.02%, 8/785), cerebrospinal fluid leakage (0.25%, 2/785), limb sensory disturbance (7.77%, 61/785); postoperative long-term complications included low back pain (2.04%, 16/785), intermittent lower extremity weakness (0.64%, 5/785), spinal deformity (0.38%, 3/785) and defecation disorder (0.13%, 1/785). After symptomatic treatment of various complications, the outcomes were satisfactory. Conclusions:SPR+ RL combined with rehabilitation can improve spasticity and limb motor function in children with SCP. The incidence of postoperative complications is low, and various complications could be treated with satisfactory outcomes.