{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T14:30:23Z","timestamp":1789828223720,"version":"4.0.1"},"reference-count":46,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2023,6,29]],"date-time":"2023-06-29T00:00:00Z","timestamp":1687996800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Objective: The objective of this study is to investigate whether age is a significant risk factor for spinal nerve injury following selective neck dissection (SND) in patients with head and neck cancer. Methods: A retrospective cohort study was conducted on patients who had undergone SND for head and neck cancer at a tertiary hospital between 2020 and 2022. The primary outcome was the incidence of spinal nerve injury after SND. The secondary outcomes included the types and severity of spinal nerve injury and the impact of age on these outcomes. Results: A total of 78 patients were included in the study and subdivided into two groups. Two shoulder-specific questionnaires (the Shoulder Pain and Disability Index (SPADI) and the Shoulder Disability Questionnaire (SDQ)) were administered to assess shoulder morbidity postoperatively. Twelve patients showed shoulder impairment following surgery. We divided the sample into two age-based groups; the older group showed a higher rate of SAN injury and the younger group showed a lower rate of improvement over time. Conclusion: This study suggests that age is a significant risk factor for spinal nerve injury following SND in patients with head and neck cancer. Older patients are more likely to experience spinal nerve injury after SND than younger patients. The findings of this study may help in the development of strategies to prevent spinal nerve injury in older patients undergoing SND for head and neck cancer.<\/jats:p>","DOI":"10.3390\/jpm13071082","type":"journal-article","created":{"date-parts":[[2023,6,30]],"date-time":"2023-06-30T00:43:30Z","timestamp":1688085810000},"page":"1082","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Does Age Affect the Rate of Spinal Nerve Injury after Selective Neck Dissection? Age as a Prognostic Factor of Spinal Nerve Injury after Selective Neck Dissection"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2374-9853","authenticated-orcid":false,"given":"Salvatore","family":"Crimi","sequence":"first","affiliation":[{"name":"Department of Biomedical and Surgical and Biomedical Sciences, Catania University, 95123 Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salvatore","family":"Battaglia","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Surgical and Biomedical Sciences, Catania University, 95123 Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Maugeri","sequence":"additional","affiliation":[{"name":"Division of Maxillofacial Surgery, Surgical Science Department, Citt\u00e0 della Salute e Delle Scienze Hospital, University of Turin, 10024 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergio","family":"Mirabella","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Surgical and Biomedical Sciences, Catania University, 95123 Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0335-4165","authenticated-orcid":false,"given":"Luca","family":"Fiorillo","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Dental Sciences, Morphological and Functional Images, University of Messina, 98100 Messina, Italy"},{"name":"Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, University of Campania \u201cLuigi Vanvitelli\u201d, 80121 Naples, Italy"},{"name":"Department of Public Health Dentistry, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pimpri 411018, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4619-4691","authenticated-orcid":false,"given":"Gabriele","family":"Cervino","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Dental Sciences, Morphological and Functional Images, University of Messina, 98100 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9374-2748","authenticated-orcid":false,"given":"Alberto","family":"Bianchi","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Surgical and Biomedical Sciences, Catania University, 95123 Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,6,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"c4684","DOI":"10.1136\/bmj.c4684","article-title":"Head and neck cancer\u2014Part 1: Epidemiology, presentation, and prevention","volume":"341","author":"Mehanna","year":"2010","journal-title":"BMJ"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"105898","DOI":"10.1016\/j.oraloncology.2022.105898","article-title":"Pattern of cervical lymph node metastases in squamous cell carcinoma of the upper oral cavity\u2014How to manage the neck","volume":"130","author":"Doll","year":"2022","journal-title":"Oral Oncol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"S1352","DOI":"10.1016\/j.annonc.2020.10.277","article-title":"283P Descriptive epidemiology of head and neck cancer in Niger: First results from the National Cancer Registry","volume":"31","author":"Garba","year":"2020","journal-title":"Ann. Oncol."},{"key":"ref_4","first-page":"1455","article-title":"Indications for Selective Neck Dissection: When, How, and Why","volume":"14","author":"Robbins","year":"2000","journal-title":"Oncology"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1199","DOI":"10.1016\/j.ejso.2016.10.026","article-title":"Prevalence, incidence, and risk factors for shoulder and neck dysfunction after neck dissection: A systematic review","volume":"43","author":"Gane","year":"2017","journal-title":"Eur. J. Surg. Oncol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1186\/s40463-021-00529-7","article-title":"Prognostic factors of head and neck cutaneous squamous cell carcinoma: A systematic review","volume":"50","author":"Lubov","year":"2021","journal-title":"J. Otolaryngol. Head Neck Surg. = J. D\u2019oto-Rhino-Laryngol. Chir. Cervico-Faciale"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1016\/S0002-9610(00)00449-9","article-title":"The anatomy of the accessory nerve and cervical lymph node biopsy","volume":"180","author":"Nason","year":"2000","journal-title":"Am. J. Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1016\/j.oraloncology.2008.05.017","article-title":"Current concepts in management of oral cancer\u2014Surgery","volume":"45","author":"Shah","year":"2009","journal-title":"Oral Oncol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"424","DOI":"10.1001\/archotol.1961.00740030433011","article-title":"A Syndrome Resulting from Radical Neck Dissection","volume":"74","author":"Nahum","year":"1961","journal-title":"Arch. Otolaryngol. Head Neck Surg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1009","DOI":"10.1177\/0194599818821885","article-title":"Neck and Shoulder Motor Function following Neck Dissection: A Comparison with Healthy Control Subjects","volume":"160","author":"Gane","year":"2019","journal-title":"Otolaryngol. Neck Surg."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1053\/j.seminoncol.2011.03.008","article-title":"Cancer Rehabilitation","volume":"38","author":"Stubblefield","year":"2011","journal-title":"Semin. Oncol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/S0895-4356(99)00078-5","article-title":"Shoulder disability questionnaire design and responsiveness of a functional status measure","volume":"53","author":"Leffers","year":"2000","journal-title":"J. Clin. Epidemiol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"619","DOI":"10.1002\/hed.23646","article-title":"Measurement of the trapezius muscle volume: A new assessment strategy of shoulder dysfunction after neck dissection for the treatment of head and neck cancers","volume":"37","author":"Cho","year":"2015","journal-title":"Head Neck"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"168","DOI":"10.3892\/etm.2020.9599","article-title":"Influence of aging on the peripheral nerve repair process using an artificial nerve conduit","volume":"21","author":"Kaneko","year":"2020","journal-title":"Exp. Ther. Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1016\/j.stem.2020.07.002","article-title":"Aging and Rejuvenation of Neural Stem Cells and Their Niches","volume":"27","author":"Negredo","year":"2020","journal-title":"Cell Stem Cell"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1016\/S1836-9553(11)70045-5","article-title":"Shoulder Pain and Disability Index (SPADI)","volume":"57","author":"Breckenridge","year":"2011","journal-title":"J. Physiother."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1007\/s12109-022-09892-3","article-title":"Fi-Index: A New Method to Evaluate Authors Hirsch-Index Reliability","volume":"38","author":"Fiorillo","year":"2022","journal-title":"Publ. Res. Q."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"684","DOI":"10.1007\/s12109-022-09920-2","article-title":"The Use of Fi-Index Tool to Assess Per-manuscript Self-citations","volume":"38","author":"Fiorillo","year":"2022","journal-title":"Publ. Res. Q."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1073","DOI":"10.1016\/j.pmrj.2014.05.015","article-title":"Quality of Life, Shoulder Range of Motion, and Spinal Accessory Nerve Status in 5-Year Survivors of Head and Neck Cancer","volume":"6","author":"Eickmeyer","year":"2014","journal-title":"PMR J. Inj. Funct. Rehabil."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1496","DOI":"10.1002\/hed.21112","article-title":"Accessory nerve function after level 2b-preserving selective neck dissection","volume":"31","author":"Celik","year":"2009","journal-title":"Head Neck"},{"key":"ref_21","unstructured":"Thawley, S.E., Panje, W.R., and Batsakis, J.G. (1999). Comprehensive Management of Head and Neck Tumors. II, W.B. Saunders Company."},{"key":"ref_22","unstructured":"Cummings, C.W., and Fredrickson, J.M. (1993). Year Book. II, Mosby. [2nd ed.]. St. Louis-Baltimore-Boston."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1080\/02844310600836810","article-title":"Iatrogenic injury to the accessory nerve","volume":"41","author":"Dahlin","year":"2007","journal-title":"Scand. J. Plast. Reconstr. Surg. Hand Surg."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1097\/WNP.0b013e31824079b3","article-title":"Neurophysiologic Monitoring of the Spinal Accessory Nerve, Hypoglossal Nerve, and the Spinomedullary Region","volume":"28","author":"Skinner","year":"2011","journal-title":"J. Clin. Neurophysiol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1001\/archotol.1993.01880140105016","article-title":"The 11th nerve syndrome. Accessory nerve palsy or adhesive capsulitis?","volume":"119","author":"Patten","year":"1993","journal-title":"Arch. Otolaryngol. Head Neck Surg."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1302\/0301-620X.93B1.24202","article-title":"Injuries to the spinal accessory nerve: A lesson to surgeons","volume":"93","author":"Camp","year":"2011","journal-title":"J. Bone Jt. Surg. Br."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"296","DOI":"10.3109\/17453678408992360","article-title":"Accessory nerve injury","volume":"55","author":"Vastamaki","year":"1984","journal-title":"Acta Orthop. Scand."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1732","DOI":"10.1016\/j.jpedsurg.2008.04.029","article-title":"Iatrogenic spinal accessory nerve injury in children","volume":"43","author":"Grossman","year":"2008","journal-title":"J. Pediatr. Surg."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1054\/jhsb.2000.0487","article-title":"Surgical anatomy of spinal accessory nerve: Is trapezius functional deficit inevitable after division of the nerve?","volume":"26","author":"Dailiana","year":"2001","journal-title":"J. Hand Surg. Br."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"488","DOI":"10.1002\/hed.2880120607","article-title":"Innervation of the trapezius muscle: A study in patients undergoing neck dissections","volume":"12","author":"Soo","year":"1990","journal-title":"Head Neck"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"78","DOI":"10.2519\/jospt.2008.2454","article-title":"Spinal Accessory Nerve Palsy: Associated Signs and Symptoms","volume":"38","author":"Kelley","year":"2008","journal-title":"J. Orthop. Sport. Phys. Ther."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1884","DOI":"10.2106\/00004623-200409000-00005","article-title":"Surgical management of trapezius palsy","volume":"86","author":"Teboul","year":"2004","journal-title":"J. Bone Jt. Surg. Am."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1097\/00003086-199911000-00003","article-title":"Spinal accessory nerve injury","volume":"368","author":"Wiater","year":"1999","journal-title":"Clin. Orthop. Relat. Res."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"611","DOI":"10.1097\/01.PRS.0000041943.47622.EB","article-title":"Management of Iatrogenic Injury to the Spinal Accessory Nerve","volume":"111","author":"Chandawarkar","year":"2003","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1015","DOI":"10.1097\/PHM.0b013e31818e6019","article-title":"Conservative Treatment for Late-Diagnosed Spinal Accessory Nerve Injury","volume":"87","author":"Akgun","year":"2008","journal-title":"Am. J. Phys. Med. Rehabil."},{"key":"ref_36","first-page":"171","article-title":"Microsurgical repair of iatrogenic accessory nerve lesions in the posterior triangle of the neck","volume":"153","author":"Osgaard","year":"1987","journal-title":"Acta Chir. Scand."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"462","DOI":"10.1007\/s00115-004-1796-2","article-title":"Management iatrogener N.-accessorius-L\u00e4sionen","volume":"76","author":"Bazner","year":"2005","journal-title":"Nervenarzt"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"690","DOI":"10.1007\/s001040050706","article-title":"Iatrogene L\u00e4sion des Nervus accessorius bei der cervicalen Lymphknotenbiopsie","volume":"70","author":"Harpf","year":"1999","journal-title":"Chirurg"},{"key":"ref_39","first-page":"515","article-title":"Peripheral injuries to the spinal accessory nerve","volume":"94","author":"Norden","year":"1946","journal-title":"Acta Chir. Scand."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1002\/micr.20239","article-title":"Surgical treatment for spinal accessory nerve injury","volume":"26","author":"Okajima","year":"2006","journal-title":"Microsurgery"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1055\/s-2005-862777","article-title":"Reconstruction of the Spinal Accessory Nerve with Autograft or Neurotube? Two Case Reports","volume":"21","author":"Ducic","year":"2005","journal-title":"J. Reconstr. Microsurg."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1616","DOI":"10.2106\/00004623-199811000-00007","article-title":"Iatrogenic Injury of the Spinal Accessory Nerve. Results of Repair","volume":"80","author":"Nakamichi","year":"1998","journal-title":"J. Bone Jt. Surg."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1492","DOI":"10.1002\/cncr.32681","article-title":"2b or not 2b? Shoulder function after level 2b neck dissection: A double-blind randomized controlled clinical trial","volume":"126","author":"Dziegielewski","year":"2020","journal-title":"Cancer"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1002\/hed.20682","article-title":"Dissection of the submuscular recess (sublevel IIb) in squamous cell cancer of the upper aerodigestive tract: Prospective study and systematic review of the literature","volume":"30","author":"Paleri","year":"2008","journal-title":"Head Neck"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1022","DOI":"10.1002\/hed.23712","article-title":"Maximizing shoulder function after accessory nerve injury and neck dissection surgery: A multicenter randomized controlled trial: Physical Therapy for Accessory Nerve Injury after Neck Dissection","volume":"37","author":"McGarvey","year":"2015","journal-title":"Head Neck"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1016\/j.bjoms.2011.09.007","article-title":"A double blind randomised trial of IIb or not IIb neck dissections on electromyography, clinical examination, and questionnaire-based outcomes: A feasibility study","volume":"50","author":"Parikh","year":"2012","journal-title":"Br. J. Oral Maxillofac. Surg."}],"container-title":["Journal of Personalized Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4426\/13\/7\/1082\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T20:03:19Z","timestamp":1760126599000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4426\/13\/7\/1082"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6,29]]},"references-count":46,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2023,7]]}},"alternative-id":["jpm13071082"],"URL":"https:\/\/doi.org\/10.3390\/jpm13071082","relation":{},"ISSN":["2075-4426"],"issn-type":[{"value":"2075-4426","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,6,29]]}}}