Neuromuscular scoliosis, often associated with cerebral palsy,

requires surgery for curves exceeding 50-60 degrees or when

functional impairments occur. While techniques such as

paravertebral (PVB), erector spinae plane (ESP), and

modified-thoracolumbar interfascial plane (m-TLIP) blocks are

effective, they can be challenging in severe cases due to

anatomical distortions. This case highlights the difficulties

encountered when applying these methods to a complex patient.