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

Background. It is the purpose of this study to determine the incidence of s houlder pain and restricted range of motion of the shoulder after neck diss ection, and to identify risk factors for the development of shoulder pain a nd restricted range of motion. Methods. Clinical patients who underwent a neck dissection completed a ques tionnaire assessing shoulder pain. The intensity of pain was assessed using a visual analog scale (100 mm). Range of motion of the shoulder was measur ed. Information about reconstructive surgery and side and type of neck diss ection was retrieved from the medical records. Results. Of the patients (n = 177, mean age 60.3 years [SID, 11.9]) 70% exp erienced pain in the shoulder. Forward flexion and abduction of the operate d side was severely reduced compared to the non-operated side, 21 degrees a nd 47 degrees, respectively. Nonselective neck dissection was a risk factor for the development of shoulder pain (9.6 mm) and a restricted shoulder ab duction (55 degrees), Reconstruction was risk factor for a restricted forwa rd flexion of the shoulder (24.5 degrees). Conclusions. Shoulder pain after neck dissection is clinically present in 7 0% of the patients. Non-selective neck dissection is a risk factor for shou lder pain and a restricted abduction. Reconstruction Is a risk factor for a restricted forward flexion of the shoulder. (C) 2001 John Wiley & Sons, In c.