Professor NYU Langone Health New York City, New York, United States
Introduction: Spine surgery has advanced in concert with our deeper understanding of pathophysiology and ability to treat it. Narrowly focused bibliometric analyses have been conducted previously, but never for the entire field. Here, we appraise more than a century of the published record and provide a scoping overview of how the specialty has evolved since 1900.
Methods: We queried Web of Science for [(spine OR spinal OR vertebrae OR vertebral OR intervertebral) AND (surgery)]. Results were filtered to include articles published by specialty-specific journals, as well as relevant sources from 1900-1950 (prior to the inception of modern specialty-specific journals). Articles, along with their metadata were exported. Statistical and bibliometric analyses were performed using the Bibliometrix R-Tool.
Results: 45,323 articles from 58 journals and 90,699 unique authors were identified. The annual growth rate of publications was 5.78%, with a surge following 1990. Over time, we observed a >50-fold increase in spine-related articles published per journal per year, indicative of a smaller number of specialized journals publishing a proportionally higher number of articles (p < 0.01). International co-authorship was absent prior to 1970, increasing to 17.66% between 2010-2022. We identified the top-10 most cited articles per decade, major modern sources and most productive authors. We saw a recent lexical evolution toward outcomes- and patient-centric terms. Reference publication year spectroscopy identified 1988-2006 as the most referenced epoch in the publication record, with historical roots in seminal biomechanical studies from the preceding decades.
Conclusion : The field of spine surgery was borne from pioneering individuals who published their findings in a variety of journals. The renaissance of spine surgery in the 1990s saw an exponential growth in the field resultant of advancements in instrumentation and spinal fusion techniques. Modern spine publications have evolved toward international collaborative efforts to hone and develop new techniques, emphasizing patient-centric outcomes.
How to Improve Patient Care: Bibliometrics is a systematic, unbiased method to analyze an increasingly vast publication record, that can provide an overall view of existing research. Appraising the literature allows for a synthesis of evolving themes and the historical roots of a field, and is one of the most critical tasks when advancing an area of research.
