Gastrostomy Tubes in Children with Nonambulatory Cerebral Palsy and Neuromuscular Scoliosis: An Enemy or an Ally?

Abstract

Gastrostomy tubes or equivalent invasive nutritional support devices are an important component for maintaining appropriate nutrition for children with cerebral palsy who have oromotor dysfunction. Although these interventions have been shown to produce positive influences on the child’s health and nutrition status, they have also been associated with increased complication rates following spinal deformity surgery. Understanding the current status of the literature on this topic as well as the gaps in knowledge are crucial to gaining a thorough understanding of the role of these feeding devices in the postoperative complication profile for these at-risk patients and avenues for future research efforts.

Impact of Scoliosis Severity on Gastrostomy-Related Complications in Children

“…Scoliosis is associated with a gastrostomy need (9,10). Disabled patients often have severe scoliosis, resulting in malpositioning of the stomach, which can complicate gastrostomy placement more difficult (11).…”

Gastrostomy Tubes in Patients With Cerebral Palsy Undergoing Surgery—Usually an Ally, but the Devil Is In the Details

“…In this issue of JPOSNA, Dr. Shiver et al review data about the role of an enterostomy feeding tube (gastrostomy/G-tube, jejunostomy/J-tube, or gastrojejunostomy/G-J tube) in patients with cerebral palsy undergoing spinal surgery for neuromuscular scoliosis. 1 The authors quite rightly comment that spinal surgery in these patients represents a significant intervention that may result in a number of respiratory, gastrointestinal, and infectious complications. These complications can have a tremendous medical, social, and psychological impact on the patient and the patient's family, so understanding a particular patient's risk factors before surgery is an important part of preoperative planning.…”