Abstract
The aim of this study was to investigate the incidence of symptoms in patients after anterior cervical spine surgery, to construct a symptom network, identify core symptoms and symptom clusters, and provide a theoretical basis for specified symptom management. A total of 375 patients who underwent anterior cervical spine surgery in a tertiary hospital in Zhejiang Province from January to August 2025 were selected using the convenience sampling method, a self-designed general information questionnaire and the MD Anderson Symptom Inventory–Head and Neck Cancer Module were used to evaluate the occurrence of patients’ symptoms. Exploratory factor analysis was conducted to extract the symptom clusters of patients after anterior cervical spine surgery. The symptom network was constructed in R language and the central indicators were analyzed. The four most common symptoms after anterior cervical spine surgery were difficulty swallowing/chewing (95.5%), sore mouth/throat (91.8%), dry mouth (91.5%), and constipation (89.1%). The four symptom clusters extracted were the pharyngolaryngeal and dysphagia symptom cluster, gastrointestinal symptom cluster, neurosensory symptom cluster, and somatic-cognitive symptom cluster, with a cumulative variance contribution rate of 66.38%. In the symptom cluster network, sore mouth/throat (rs = 2.08), difficulty swallowing/chewing (rs = 1.29), fatigue (rs = 1.19), and dry mouth (rs = 0.97) were the strongest symptoms among the four symptom groups. Sore mouth/throat, difficulty swallowing/chewing, fatigue, and dry mouth are the core symptoms of patients after anterior cervical spine surgery, and the pharyngolaryngeal and dysphagia symptom cluster is the core symptom cluster. It is recommended that medical staff formulate interventions according to the core symptoms and symptom clusters of patients. In addition, precise symptom management should be implemented.
Data availability
The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.
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Funding
This work was supported by the Zhejiang Traditional Chinese Medicine Science and Technology Program Project (grant number 2024ZL581), and the General Research Project of the Zhejiang Provincial Department of Education (grant number Y202352208).
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Ma YJ and Sheng SY: Study concept and design, Data collection, Data analysis, Manuscript drafts; Zheng LM and Ren Y: Study concept and design, Data analysis, Manuscript drafts; Wang MM and Yu QF: Data collection, Data analysis; Yu CF, Liang N, and Lv DD: Data collection, Manuscript drafts; Ye Q: Study concept and design, Data collection, Data analysis, Manuscript drafts, Supervision. All authors had full access to all the data in the study, and the corresponding author had final responsibility for the decision to submit for publication. The corresponding author attests that all listed authors meet authorship criteria and that no others meeting the criteria have been omitted.
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This study was approved by the Human Research Ethics Committee of the Second Affiliated Hospital of Zhejiang University School of Medicine (Approval No. I2024217). All participants were given questionnaires after signing the informed consent form. Our research adhered to the Declaration of Helsinki.
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Ma, Yj., Sheng, Sy., Zheng, Lm. et al. Symptom clusters and symptom network analysis of patients after anterior cervical spine surgery: a cross-sectional study. Sci Rep (2026). https://doi.org/10.1038/s41598-026-38585-6
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DOI: https://doi.org/10.1038/s41598-026-38585-6
