中枢性瘫痪由大脑或脊髓运动传导通路受损引起，以卒中、脊髓损伤为主要病因，常导致肢体运动障碍、痉挛及感觉功能异常，严重影响患者的生活质量，带来了沉重的社会负担。近年来，神经调控技术，如脊髓电刺激（SCS），因其微创、可逆等优势成为其治疗研究热点。SCS通过硬膜外电极向脊髓背侧发送电脉冲，从而降低肌张力、缓解痉挛与疼痛、促进运动功能恢复，作用机制包括调节神经可塑性、感觉传入、脊髓运动神经元兴奋性及神经递质释放等。相较于传统外科手术及其他神经调控技术，SCS具有非破坏性、作用直接、适用范围广（可能改善意识、二便障碍等）的优势。未来SCS将结合多通道电极、智能算法、闭环调控及机器人辅助康复等技术，提升其精准性与疗效，成为神经康复核心技术之一。本文围绕SCS治疗中枢性瘫痪的现状、手术适应证与禁忌证、手术方法、术后管理及疗效进行述评。

Central paralysis is caused by damage to motor conduction pathways in the brain or spinal cord， most commonly due to stroke or spinal cord injury. It often results in motor dysfunction，spasticity， and sensory abnormalities， severely impairing patients' quality of life and imposing a substantial societal burden. In recent years， neuromodulation techniques， particularly spinal cord stimulation （SCS）， have attracted increasing attention due to their minimally invasive and reversible nature. SCS delivers electrical pulses to the dorsal spinal cord via epidural electrodes， thereby reducing muscle tone， alleviating spasticity and pain， and promoting motor recovery. Its therapeutic mechanisms involve modulation of neural plasticity， sensory afferent input， excitability of spinal motor neurons， and neurotransmitter release. Compared with traditional surgery and other neuromodulation approaches， SCS offers non-destructive， direct action with a wide range of potential benefits， including improvements in consciousness and autonomic dysfunction. Future development of SCS is expected to incorporate multichannel electrodes， intelligent algorithms， closed-loop control， and robot-assisted rehabilitation，enhancing both precision and efficacy. This article reviews the current situation， surgical indications and contraindications， surgical methods， postoperative management and therapeutic outcomes of SCS in the treatment of central paralysis.