Introduction:
Spina bifida, often linked to tethered cord syndrome (scar tissue), can cause spinal cord lesions, potentially damaging surrounding nerves and leading to dystonia—a debilitating muscular disorder affecting up to 40% of Spina Bifida patients. This case highlights the unpredictable nature of Spina Bifida-associated dystonia and its impact on rehabilitation outcomes.

Case Description/Discussion:
A 19-year-old male with Spina Bifida developed a fluid-filled spinal lesion, resulting in L1-L3 damage and dystonia in his lower extremities, primarily affecting the ankles. PT goals focused on improving knee and ankle mobility to enhance functional movement without AFO braces. Despite the irreversible damage, the patient showed slight improvements in ankle dystonia management, an uncommon outcome given the typically poor prognosis. This case underscores the variability in Spina Bifida rehabilitation and the need for further research on dystonia screening and treatment.

Goals:
This case report provided first hand insight into neurological rehabilitation complexities. Observing the patient’s challenges and progress deepened my understanding of targeted interventions, at-home programs, rehabilitation outcomes, and ethical considerations in managing complex neurological cases. By observing the challenges and limitations that the patient faced in improving dystonia and motor function, as well as the meaningful progress they made, my goal was met as I gained knowledge about targeted-interventions, at-home-programs, rehabilitation outcomes, and ethics for complex neurological patients.