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Evaluation of Neck Disability Using Computed-Tomography in Head and Neck Cancer Survivors

OBJECTIVE: We have previously reported that 55% of head and neck cancer survivors have neck disability. However, it is unclear what factors contribute to their neck disability. Our study aim is to determine if survivors with neck disability have evidence of cervical spine degenerative disease assess...

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Autores principales: Harris, Alexandria, Branstetter, Barton, Li, Jinhong, Piva, Sara R., Johnson, Jonas T., Nilsen, Marci Lee
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9152144/
https://www.ncbi.nlm.nih.gov/pubmed/35655749
http://dx.doi.org/10.3389/fpain.2022.910247
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author Harris, Alexandria
Branstetter, Barton
Li, Jinhong
Piva, Sara R.
Johnson, Jonas T.
Nilsen, Marci Lee
author_facet Harris, Alexandria
Branstetter, Barton
Li, Jinhong
Piva, Sara R.
Johnson, Jonas T.
Nilsen, Marci Lee
author_sort Harris, Alexandria
collection PubMed
description OBJECTIVE: We have previously reported that 55% of head and neck cancer survivors have neck disability. However, it is unclear what factors contribute to their neck disability. Our study aim is to determine if survivors with neck disability have evidence of cervical spine degenerative disease assessed by computed tomography (CT). MATERIALS/METHODS: Cross-sectional analysis of patient-reported neck disability, prospectively collected on survivors of squamous cell carcinomas without recurrence or metastasis over one-year post-treatment. Neck disability and its impact on daily life was measured using the Neck Disability Index (NDI) and compared with cervical CT scans within 6 months. Scans were evaluated for degeneration of the disc and facet of the cervical vertebrae rated on a 5-point scale where 5 indicates more severe disease. Multivariable linear regression was used to analyze the association between NDI and radiographic findings. RESULTS: 116 survivors of oropharyngeal carcinomas were identified, predominantly male (81.9%) with an average age of 62.8 ± 8.2 (range 43.8–81.4). Most survivors had advanced stage III-IVa cancer (94.0%) with treatment modalities including surgery (n=26, 52.0%), chemotherapy (n = 45, 90.0%), and radiation therapy (n = 49, 98.0%). Absence of neck disability was observed in 44.0% of survivors, 39.7% had mild disability, and 16.4% moderate disability. The time from treatment to clinic visit was an average of 3.1 ± 2.7 years (range 1.1–13.4). Multivariable analysis of NDI controlling for age, time since treatment, and treatment modality identified an inverse association between NDI and spinal degenerative disease examining cervical discs (−1.46 95% confidence interval (CI) [−2.86, −0.06], p = 0.041) and age (−0.24 95% CI[−0.40, −0.08], p = 0.004). CONCLUSIONS: Our study shows that neck impairment and pain in head and neck cancer survivors is not sufficiently explained by cervical degeneration related to age or trauma, supporting the theory that post-treatment neck disability occurs as a side effect of treatment. These results support the further assessment of structure and function of cervical musculature and degeneration following HNC treatment.
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spelling pubmed-91521442022-06-01 Evaluation of Neck Disability Using Computed-Tomography in Head and Neck Cancer Survivors Harris, Alexandria Branstetter, Barton Li, Jinhong Piva, Sara R. Johnson, Jonas T. Nilsen, Marci Lee Front Pain Res (Lausanne) Pain Research OBJECTIVE: We have previously reported that 55% of head and neck cancer survivors have neck disability. However, it is unclear what factors contribute to their neck disability. Our study aim is to determine if survivors with neck disability have evidence of cervical spine degenerative disease assessed by computed tomography (CT). MATERIALS/METHODS: Cross-sectional analysis of patient-reported neck disability, prospectively collected on survivors of squamous cell carcinomas without recurrence or metastasis over one-year post-treatment. Neck disability and its impact on daily life was measured using the Neck Disability Index (NDI) and compared with cervical CT scans within 6 months. Scans were evaluated for degeneration of the disc and facet of the cervical vertebrae rated on a 5-point scale where 5 indicates more severe disease. Multivariable linear regression was used to analyze the association between NDI and radiographic findings. RESULTS: 116 survivors of oropharyngeal carcinomas were identified, predominantly male (81.9%) with an average age of 62.8 ± 8.2 (range 43.8–81.4). Most survivors had advanced stage III-IVa cancer (94.0%) with treatment modalities including surgery (n=26, 52.0%), chemotherapy (n = 45, 90.0%), and radiation therapy (n = 49, 98.0%). Absence of neck disability was observed in 44.0% of survivors, 39.7% had mild disability, and 16.4% moderate disability. The time from treatment to clinic visit was an average of 3.1 ± 2.7 years (range 1.1–13.4). Multivariable analysis of NDI controlling for age, time since treatment, and treatment modality identified an inverse association between NDI and spinal degenerative disease examining cervical discs (−1.46 95% confidence interval (CI) [−2.86, −0.06], p = 0.041) and age (−0.24 95% CI[−0.40, −0.08], p = 0.004). CONCLUSIONS: Our study shows that neck impairment and pain in head and neck cancer survivors is not sufficiently explained by cervical degeneration related to age or trauma, supporting the theory that post-treatment neck disability occurs as a side effect of treatment. These results support the further assessment of structure and function of cervical musculature and degeneration following HNC treatment. Frontiers Media S.A. 2022-05-17 /pmc/articles/PMC9152144/ /pubmed/35655749 http://dx.doi.org/10.3389/fpain.2022.910247 Text en Copyright © 2022 Harris, Branstetter, Li, Piva, Johnson and Nilsen. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pain Research
Harris, Alexandria
Branstetter, Barton
Li, Jinhong
Piva, Sara R.
Johnson, Jonas T.
Nilsen, Marci Lee
Evaluation of Neck Disability Using Computed-Tomography in Head and Neck Cancer Survivors
title Evaluation of Neck Disability Using Computed-Tomography in Head and Neck Cancer Survivors
title_full Evaluation of Neck Disability Using Computed-Tomography in Head and Neck Cancer Survivors
title_fullStr Evaluation of Neck Disability Using Computed-Tomography in Head and Neck Cancer Survivors
title_full_unstemmed Evaluation of Neck Disability Using Computed-Tomography in Head and Neck Cancer Survivors
title_short Evaluation of Neck Disability Using Computed-Tomography in Head and Neck Cancer Survivors
title_sort evaluation of neck disability using computed-tomography in head and neck cancer survivors
topic Pain Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9152144/
https://www.ncbi.nlm.nih.gov/pubmed/35655749
http://dx.doi.org/10.3389/fpain.2022.910247
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