Improving Quality of Life Through Selective Dorsal Rhizotomy in a Pediatric Patient with Cerebral Palsy and Spastic Quadriparesis: A Rare Case with Twisted Conus Medullaris

Background: Cerebral palsy (CP) is a permanent movement disorder characterized by abnormal motor controland posture, often leading to significant physical disability. A common feature of CP, spasticity, results fromdamage to upper motor neurons, causing muscle stiffness and involuntary contractions. Selective dorsalrhizotomy (SDR) is a neurosurgical procedure aimed at reducing spasticity in CP patients.Case Description: A 6-year-old male with spastic quadriparesis due to infancy spasticity in the right hand andlower limbs underwent SDR after physiotherapy failed to alleviate his severe spasticity. Neurologicalexamination revealed spastic paraparesis in the lower extremities and a history of seizures. MRI confirmed thenecessity for surgical intervention due to abnormalities from vertebrae Th12 to L1. The patient underwent SDRunder general anesthesia, targeting spinal roots from L3 to S1. The immediate postoperative period wasuneventful, with no major complications reported. This suggests that SDR can be safely performed in pediatricpatients with CP and severe spasticity.