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Coexistence of Neck and Shoulder Disability: Results of a Population-Based Cross-Sectional Study on Normative Scores and Multifactorial Risk Factors for Neck and Shoulder Problems

Asian Spine Journal 2021년 15권 2호 p.180 ~ 191
Koller Juliane, Bismarck Carsten, Krebs Sona, Hitzl Wolfgang, Mayer Michael, Koller Heiko,
소속 상세정보
 ( Koller Juliane ) - Hospital zum Heiligen Geist Fritzlar Department of General Surgery and Traumatology
 ( Bismarck Carsten ) - Hospital zum Heiligen Geist Fritzlar Department of General Surgery and Traumatology
 ( Krebs Sona ) - Hospital zum Heiligen Geist Fritzlar Department of General Surgery and Traumatology
 ( Hitzl Wolfgang ) - Paracelsus Medical University Salzburg Research Office Biostatistics
 ( Mayer Michael ) - Schoen-Klinik Vogtareuth Center for Spine and Scoliosis Surgery
 ( Koller Heiko ) - Paracelsus Medical University Salzburg Department for Orthopedic Surgery and Traumatology

Abstract


Study Design: Cross-sectional population-based study.

Purpose: The study objective was to evaluate the coexistence of neck- and shoulder-disability, to establish normative scores for Neck Disability Index (NDI), Visual Analog Scale (VAS)-neck, VAS-arm, Quick Disability of Shoulder and Hand (Quick-DASH), and modified Constant score (mConstant score), and to determine the influence of psychological distress (Hospital Anxiety and Depression Scale [HADS]) on the disability measures. The authors also investigated the distribution of dysphagia across the population and its relation to the NDI scores.

Overview of Literature: Several factors can adversely influence the clinical outcomes after cervical surgeries. The interaction of neck and shoulder disability in the perspective of psychological distress is not well understood.

Methods: Prospective questionnaire-based assessment was performed for 1,000 participants. Questionnaires consisted of validated generic and disease-specific queries and specific questions. The survey included patients without pathologies of cervical spine/shoulders/upper extremities.

Results: Mean age of participants was 39 years. The average neck VAS score was 1.2, NDI% was 7.3, arm VAS score was 0.8, Quick-DASH was 6.2, mConstant score was 70.7, HADS-A score was 4.9, and HADS-D score was 3.2. The psychological scores showed a significant correlation with neck- and shoulder-disability (p<0.0001, r=0.3 to r=0.5). However, correlations between neck (NDI%, neck VAS score) and shoulder disability (mConstant score, arm VAS score, Quick-DASH) were stronger (p<0.0001, r=0.5 to r=0.6). A body mass index >35 kg/m2 influenced shoulder-disability (p<0.005) and psychological distress (HADS-D score, p<0.00001). Limited neck rotation was present in those with higher age, psychological distress, neck and shoulder disability (p<0.001).

Conclusions: Normative scores for neck and shoulder disability were established. The outcomes of cervical spine surgery can be normalized to these results. A better understanding of the interdependencies of neck and shoulder disability and psychological distress would enable superior decision-making and patient counseling.

키워드

Cervical; Spine; Neck Disability Index; Normal scores; Dysphagia; Depression

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