Gastroesophageal evaluation in totally involved cerebral palsy patients

Fifty-two nonambulatory totally-involved cerebral palsy patients with spinal deformity who had barium swallow examinations of their gastroesophageal tract as part of their preoperative evaluation were retrospectively reviewed. Thirty-six patients (69%) were identified with abnormalities of their swallowing mechanism. Subnormal nutritional indices were identified as well in 41 patients (79%). Ten of 38 patients undergoing spinal surgery developed significant postoperative complications. Nine of the 10 complications occurred in patients in whom gastroesophageal or nutritional abnormalities were identified but not addressed before spinal surgery. We recommend gastroesophageal and nutritional evaluation of all patients with cerebral palsy before spinal surgery.