Asian Spine J.  2021 Apr;15(2):180-191. 10.31616/asj.2019.0397.

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

Affiliations
  • 1Department of General Surgery and Traumatology, Hospital zum Heiligen Geist Fritzlar, Fritzlar, Germany
  • 2Center for Spine and Scoliosis Surgery, Schoen-Klinik Vogtareuth, Vogtareuth, Germany
  • 3Research Office for Biostatistics, Paracelsus Medical University Salzburg, Salzburg, Austria
  • 4Department for Orthopedic Surgery and Traumatology, Paracelsus Medical University Salzburg, Salzburg, Austria
  • 5Department of Neurosurgery, Klinikum Rechts der Isar, Technical University of Munich, München, Germany

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, QuickDASH 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.

Keyword

Cervical; Spine; Neck Disability Index; Normal scores; Dysphagia; Depression
Full Text Links
  • ASJ
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr