{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T01:41:52Z","timestamp":1781228512955,"version":"3.54.1"},"reference-count":31,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,5,17]],"date-time":"2022-05-17T00:00:00Z","timestamp":1652745600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pain Res."],"abstract":"Objective<\/jats:title>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).<\/jats:p><\/jats:sec>Materials\/Methods<\/jats:title>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.<\/jats:p><\/jats:sec>Results<\/jats:title>116 survivors of oropharyngeal carcinomas were identified, predominantly male (81.9%) with an average age of 62.8 \u00b1 8.2 (range 43.8\u201381.4). Most survivors had advanced stage III-IVa cancer (94.0%) with treatment modalities including surgery (n=26, 52.0%), chemotherapy (n<\/jats:italic> = 45, 90.0%), and radiation therapy (n<\/jats:italic> = 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 \u00b1 2.7 years (range 1.1\u201313.4). 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 (\u22121.46 95% confidence interval (CI) [\u22122.86, \u22120.06], p<\/jats:italic> = 0.041) and age (\u22120.24 95% CI[\u22120.40, \u22120.08], p<\/jats:italic> = 0.004).<\/jats:p><\/jats:sec>Conclusions<\/jats:title>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.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpain.2022.910247","type":"journal-article","created":{"date-parts":[[2022,5,17]],"date-time":"2022-05-17T05:43:13Z","timestamp":1652766193000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Evaluation of Neck Disability Using Computed-Tomography in Head and Neck Cancer Survivors"],"prefix":"10.3389","volume":"3","author":[{"given":"Alexandria","family":"Harris","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barton","family":"Branstetter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinhong","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara R.","family":"Piva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonas T.","family":"Johnson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marci Lee","family":"Nilsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,5,17]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"386","DOI":"10.1016\/j.mayocp.2015.12.017","article-title":"Head and neck squamous cell carcinoma: update on epidemiology, diagnosis, and treatment","volume":"91","author":"Marur","year":"2016","journal-title":"Mayo Clin Proc."},{"key":"B2","doi-asserted-by":"publisher","first-page":"994","DOI":"10.1634\/theoncologist.2009-0289","article-title":"Changes in survival in head and neck cancers in the late 20th and early 21st century: a period analysis","volume":"15","author":"Pulte","year":"2010","journal-title":"Oncologist."},{"key":"B3","doi-asserted-by":"publisher","first-page":"4294","DOI":"10.1200\/JCO.2011.36.4596","article-title":"Human papillomavirus and rising oropharyngeal cancer incidence in the United States","volume":"29","author":"Chaturvedi","year":"2011","journal-title":"J Clin Oncol."},{"key":"B4","doi-asserted-by":"publisher","first-page":"4550","DOI":"10.1200\/JCO.2013.50.3870","article-title":"Worldwide trends in incidence rates for oral cavity and oropharyngeal cancers","volume":"31","author":"Chaturvedi","year":"2013","journal-title":"J Clin Oncol."},{"key":"B5","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1056\/NEJMoa0912217","article-title":"Human papillomavirus and survival of patients with oropharyngeal cancer","volume":"363","author":"Ang","year":"2010","journal-title":"N Engl J Med."},{"key":"B6","doi-asserted-by":"publisher","first-page":"576","DOI":"10.1038\/nature14129","article-title":"Comprehensive genomic characterization of head and neck squamous cell carcinomas","volume":"517","author":"Network","year":"2015","journal-title":"Nature."},{"key":"B7","doi-asserted-by":"publisher","first-page":"3582","DOI":"10.1200\/JCO.2007.14.8841","article-title":"Factors associated with severe late toxicity after concurrent chemoradiation for locally advanced head and neck cancer: an RTOG analysis","volume":"26","author":"Machtay","year":"2008","journal-title":"J Clin Oncol."},{"key":"B8","doi-asserted-by":"publisher","first-page":"619","DOI":"10.1007\/s11764-018-0697-5","article-title":"The relationship between physical impairments, quality of life and disability of the neck and upper limb in patients following neck dissection","volume":"12","author":"Gane","year":"2018","journal-title":"J Cancer Surviv."},{"key":"B9","doi-asserted-by":"publisher","first-page":"e0234061","DOI":"10.1371\/journal.pone.0234061","article-title":"Muscle fat infiltration following whiplash: a computed tomography and magnetic resonance imaging comparison","volume":"15","author":"Elliott","year":"2020","journal-title":"PLoS ONE."},{"key":"B10","doi-asserted-by":"publisher","first-page":"2085","DOI":"10.1007\/s00520-017-3603-1","article-title":"Assessment of musculoskeletal impairment in head and neck cancer patients","volume":"25","author":"Ghiam","year":"2017","journal-title":"Support Care Cancer."},{"key":"B11","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1002\/hed.21689","article-title":"Morbidity of supraomohyoidal and modified radical neck dissection combined with radiotherapy for head and neck cancer. 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