Incidence of shoulder pain after neck dissection: A clinical explorative study for risk factors

Authors

  • Pieter U. Dijkstra PhD,

    Corresponding author
    1. University Hospital Groningen, Department of Oral and Maxillofacial Surgery, P.O. Box 30.001, 9700 RB, Groningen, The Netherlands
    2. Pain Center, University Hospital Groningen, Groningen, The Netherlands
    3. Dept of Rehabilitation, University Hospital Groningen, Groningen, The Netherlands
    • University Hospital Groningen, Department of Oral and Maxillofacial Surgery, P.O. Box 30.001, 9700 RB, Groningen, The Netherlands
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  • Paul C. van Wilgen BSc,

    1. University Hospital Groningen, Department of Oral and Maxillofacial Surgery, P.O. Box 30.001, 9700 RB, Groningen, The Netherlands
    2. Pain Center, University Hospital Groningen, Groningen, The Netherlands
    3. Dept of Rehabilitation, University Hospital Groningen, Groningen, The Netherlands
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  • Ron P. Buijs BSc,

    1. University Hospital Rotterdam/Daniel, P.O. Box 5201, 3075 EA, Rotterdam, The Netherlands
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  • Wim Brendeke BSc,

    1. Rijnstate Hospital Arnhem, P.O. Box 9555, 6800 TA, Arnhem, The Netherlands
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  • Cornelis J. T. de Goede BSc,

    1. University Hospital Vrije Universiteit Amsterdam, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands
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  • Ad Kerst BSc,

    1. University Hospital Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
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  • Muriel Koolstra BSc,

    1. University Hospital Vrije Universiteit Amsterdam, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands
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  • Johan Marinus MSc,

    1. Haaglanden Medical Center, P.O. Box 432, 2501 CK, Den Haag, The Netherlands
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  • Elisabeth M. Schoppink MSc,

    1. Haaglanden Medical Center, P.O. Box 432, 2501 CK, Den Haag, The Netherlands
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  • Martijn M. Stuiver BSc,

    1. Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
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  • Caroline F. van de Velde MSc,

    1. University Hospital Maastricht, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands
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  • Jan L. N. Roodenburg PhD

    1. University Hospital Groningen, Department of Oral and Maxillofacial Surgery, P.O. Box 30.001, 9700 RB, Groningen, The Netherlands
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Abstract

Background

It is the purpose of this study to determine the incidence of shoulder pain and restricted range of motion of the shoulder after neck dissection, and to identify risk factors for the development of shoulder pain and restricted range of motion.

Methods

Clinical patients who underwent a neck dissection completed a questionnaire assessing shoulder pain. The intensity of pain was assessed using a visual analog scale (100 mm). Range of motion of the shoulder was measured. Information about reconstructive surgery and side and type of neck dissection was retrieved from the medical records.

Results

Of the patients (n = 177, mean age 60.3 years [SD, 11.9]) 70% experienced pain in the shoulder. Forward flexion and abduction of the operated side was severely reduced compared to the non-operated side, 21° and 47°, respectively. Non-selective neck dissection was a risk factor for the development of shoulder pain (9.6 mm) and a restricted shoulder abduction (55°). Reconstruction was risk factor for a restricted forward flexion of the shoulder (24.5°).

Conclusions

Shoulder pain after neck dissection is clinically present in 70% of the patients. Non-selective neck dissection is a risk factor for shoulder pain and a restricted abduction. Reconstruction is a risk factor for a restricted forward flexion of the shoulder. © 2001 John Wiley & Sons, Inc. Head Neck 23: 947–953, 2001.

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