J Neurosurg Pediatr. 2025 Aug 1:1-8. doi: 10.3171/2025.4.PEDS25100. Online ahead of print.
ABSTRACT
OBJECTIVE: This study aimed to investigate the effect of intrathecal baclofen (ITB) on BMI over time in a large pediatric cohort of patients with cerebral palsy (CP).
METHODS: The medical records of pediatric patients diagnosed with CP who underwent ITB pump placement at Texas Children’s Hospital between 2007 and 2024 were retrospectively reviewed. Pre- and postoperative BMI, demographic information, and clinical characteristics were collected. Multiple BMI velocities were calculated. A linear mixed-effects model was used to account for interpatient variability.
RESULTS: Among 237 patients, the average BMI was 17.90 (SD 4.00) kg/m2 preoperatively and 19.13 (SD 4.58) kg/m2 postoperatively, showing a significant difference (p = 0.001, Kruskal-Wallis test) but a small effect size (η2 = 0.02, 95% CI 0.001-0.05). The average BMI velocity was 0.55 (SD 3.5) kg/m2/yr presurgery and 0.46 (SD 3.5) kg/m2/yr postsurgery, showing no significant difference (p = 0.52, t-test). The mixed-effects model found no statistically significant effect of ITB surgery on BMI rate of change by catheter level. Specifically, cervical (p = 0.97), high thoracic (p = 0.41), midthoracic (p = 0.63), and low thoracic (p = 0.84) catheter levels were nonsignificant in effect on BMI.
CONCLUSIONS: Although there was an absolute increase in BMI postoperatively, the small effect size and results of the linear mixed-effects model-accounting for clinical confounders, within-patient variability, and catheter level-demonstrated that ITB surgery does not significantly affect BMI. The authors conclude that improved tone control may not substantially impact BMI, necessitating further nutritional intervention to ensure optimal BMI.
PMID:40749238 | DOI:10.3171/2025.4.PEDS25100
