Which procedure is a selective neurosurgical intervention to reduce spasticity in cerebral palsy?

• A. Selective dorsal rhizotomy
• B. Tendon release
• C. Distal femoral extension osteotomy
• D. Acetabular/femoral osteotomies

Answer: (A)

The key idea here is targeted neural modulation to reduce spasticity. Selective dorsal rhizotomy is a neurosurgical procedure that cuts specific dorsal rootlets in the lumbosacral spine, chosen based on intraoperative testing, to decrease the abnormal reflex activity driving spasticity. By reducing the input that overexcites alpha motor neurons, it lowers hyperactive stretch reflexes while trying to preserve voluntary movement and strength. This direct neural intervention is distinct from other options, which are orthopedic or musculoskeletal approaches: tendon release loosens tight muscles but doesn’t alter neural drive; distal femoral extension osteotomy and acetabular/femoral osteotomies realign bones and hips without changing spasticity. So the dorsal rootlet selective pruning is the selective neurosurgical method to lessen spasticity.