Spasticity is a debilitating and stubborn pathology that may result from various central nervous system insults such as spinal cord injury, traumatic brain injury, cerebral palsy, and stroke. Current treatment paradigms favor the use of non-surgical measures, including oral muscle relaxants, botulinum toxin and phenol injections, and physical therapy. These interventions often fail to provide enduring relief. Surgical options, such as the placement of an intrathecal baclofen pump may reduce tone, but do not improve walking speed. Patients who experience persistent, severe disability may be candidates for partial denervation procedures through highly selective neurectomy (HSN), an effective and low-risk modality to reduce spasticity and improve function (Mahan MA et al., Neurosurgery 89:827–835, 2021; Leclercq C, Hand Clin 34:537–545, 2018; Sindou M et al., Neurosurgery for spasticity, a practical guide for treating children and adults. Springer, Switzerland, 2022)