The top 100 classic papers in lumbar spine surgery

Trends of Low Back Pain Research in Older and Working-Age Adults from 1993 to 2023: A Bibliometric Analysis

Although the number of publications focusing on low back pain in older adults (LBP-O) and working-age adults (LBP-W) has been growing for decades, comparative research trends in these two populations, which may help to guide future investigation, have not been rigorously explored. This analysis aimed to describe publication patterns and trends of research targeting LBP-O and LBP-W over the last three decades. Peer-reviewed LBP-O and LBP-W articles published between 1993 and 2023 were retrieved from the Web of Science, which provided the details of annual publication volume, and prominent journals/countries/institutions. The relationship between the annual publication volumes and years was analyzed by Spearman correlation analysis. The hot topics and emerging trends were analyzed by VOSviewer and CiteSpace, respectively. A total of 4217 LBP-O-related and 50,559 LBP-W-related documents were included. The annual publication volumes of LBP-O and LBP-W articles increased over the years (r=0.995 to 0.998, p<0.001). The United States had the highest number of prominent institutions publishing relevant articles. The most prolific journal for LBP-O (5.4%) and LBP-W-related (6.1%) papers is the journal "Spine". Cognitive behavioral therapy, intervertebral disc (IVD) degeneration, physiotherapy, physical activity, and walking were the recent hot topics and physical activity was an emerging trend in LBP-O, while surgery and IVD degeneration (also a hot topic) were emerging trends in LBP-W. This study highlights the paucity of LBP-O-related research in the past. The United States and the journal Spine stand out in LBP research. The research trend of physical activity in LBP-O is consistent with the recognized importance of physical activity for older adults in general, and for managing LBP-O in particular. Conversely, the emerging trends of surgery and intervertebral disc degeneration in LBP-W research highlight a focus on the biomedical model of LBP despite LBP being a biopsychosocial condition.

Bibliometric analysis of the 100 most cited articles in nonspecific neck pain research: A STROBE-compliant study

The purpose of this study was to identify and analyze the top 100 cited articles in nonspecific neck pain (NSNP) research. A set of search terms was entered into the Web of Science database, and the articles with the highest citation counts in the field of NSNP were chosen. The top 100 articles were examined for total citation count, annual citations count, first author, year of publication, journal, study design, and country of origin. The citation count for the list final articles ranged from 181 to 2067, with an average of 291.9. The journal Spine contributed the most articles (25), followed by pain (16). Between 2001 and 2010, the most prolific years, 66 articles were published. In terms of country of origin, the majority of articles were from Australia (22). Vernon H., published the most cited article in the Journal of Manipulative & Physiological Therapeutics in 1991, reporting the first instrument developed to assess self-reported disability in patients with neck pain. The bibliographic analysis to identify the top 100 most cited articles related to NSNP acknowledges the field historical advances and provides insight into the types of articles that have provided these advances.

Publication rates of abstracts presented across 6 major spine specialty conferences

Background

Although scientific researchers aim to present their projects at academic conferences as a step toward publication, not all projects mature to become a peer-reviewed manuscript. The publication rate of meetings can be utilized to assess the quality of presented research. Our objective was to evaluate the contemporary publication rate of abstracts presented at spine conferences.

Methods

We reviewed annual meeting programs of North American Spine Society (NASS), Scoliosis Research Society (SRS), International Meeting on Advanced Spine Techniques (IMAST), Spine Global Spine Congress (GSC), Lumbar Spine Research Society (LSRS), and Cervical Spine Research Society (CSRS) from 2017 to 2019. Abstracts were identified as published from PubMed and Google search. From published manuscripts, journal name and open access status was collected. Journal impact factors were collected from the 2021 Journal Citation Reports.

Results

A total of 3,091/5,722 (54%) abstracts were published, ranging from 44.5% to 66.3%. Publication rate of posters and podiums ranged from 39.8% to 64.8% and 51.6% to 67.2%, respectively. Podium presentations were more likely to be published than posters (59.6% vs. 47.2%, p<.001). Only NASS (61.4% vs. 61.8%) and LSRS (64.6% vs. 67.2%) demonstrated similar publication rates for posters and podiums. Award nominated abstracts had a significantly higher publication rate (68.0% vs. 53.4%, p<.001). Among journals with an impact factor, the median overall impact factor was 3.27 and was similar between all conferences except GSC, which was slightly lower (2.72 vs. 3.27, p<.001).

Conclusions

Fifty-four percent of abstracts were published with 3 societies (NASS, LSRS, and SRS) having rates of over 60%. Moreover, NASS and LSRS demonstrated high publication rates regardless of presentation type. These numbers are significantly higher than previous reports suggesting that these conferences allow attendees to review high quality evidence that is likely to achieve peer-reviewed publication while obtaining an early look at original research.

Defining age-adjusted spinopelvic alignment thresholds: should we integrate BMI?

PURPOSE

To develop age- and BMI-adjusted alignment targets to improve patient-specific management and operative treatment outcomes.

METHODS

Retrospective review of a single-center stereographic database. ASD patients receiving operative or non-operative treatment, ≥ 18y/o with complete baseline (BL) ODI scores and radiographic parameters (PT, SVA, PILL, TPA) were included. Patients were stratified by age consistent with US-Normative values (norms) of SF-36(< 35, 35-55, 45-54, 55-64, 65-74, ≥ 75y/o), and dichotomized by BMI (Non-Obese < 30; Obese ≥ 30). Linear regression analysis established normative age- and BMI-specific radiographic thresholds, utilizing previously published age-specific US-Normative ODI values converted from SF-36 PCS (Lafage et al.), in conjunction with BL age and BMI means.

RESULTS

486 patients were included (Age: 52.5, Gender: 68.7%F, mean BMI: 26.2, mean ODI: 32.7), 135 of which were obese. Linear regression analysis developed age- and BMI-specific alignment thresholds, indicating PT, SVA, PILL, and TPA to increase with both increased age and increased BMI (all R > 0.5, p < 0.001). For non-obese patients, PT, SVA, PILL, and TPA ranged from 10.0, - 25.8, - 9.0, 3.1 in patients < 35y/o to 27.8, 53.4, 17.7, 25.8 in patients ≥ 75 y/o. Obese patients' PT, SVA, PILL, and TPA ranged from 10.5, - 7.6, - 7.1, 5.8 in patients < 35 y/o to 28.3, 67.0, 19.15, 27.7 in patients ≥ 75y/o. Normative SVA values in obese patients were consistently ≥ 10 mm greater compared to non-obese values, at all ages.

CONCLUSION

Significant associations exist between age, BMI, and sagittal alignment. While BMI influenced age-adjusted alignment norms for PT, SVA, PILL, and TPA at all ages, obesity most greatly influenced SVA, with normative values similar to non-obese patients who were 10 years older. Age-adjusted alignment thresholds should take BMI into account, calling for less rigorous alignment objectives in older and obese patients.

The 100 Most Cited Articles on Lumbar Spinal Stenosis: A Bibliometric Analysis

STUDY DESIGN

Bibliometric analysis.

OBJECTIVE

With the increasing literature of spine surgery, some pioneering research studies have had a significant impact on the field of lumbar spinal stenosis (LSS). The objective of the authors was to identify and analyze the most frequently cited 100 articles in this field.

METHODS

Web of Science was searched to identify 100 top-cited articles related to LSS from 2000 to 2019. Articles on the final list were filtered based on their titles and abstracts. The following information were recorded and analyzed with bibliometric method: article title, first author, year of publication, journal of publication, total number of citations, country, institution, and study topic.

RESULTS

The citation count for final articles on the list ranged from 71 to 2162, with a mean number of 207.7. The journal Spine contributed the maximum number of articles (37), followed by European Spine Journal (9) and Pain Physician (8). There were collectively 80 first authors contributing to articles on the final list. Twelve authors were represented multiple times in the top 100 articles. The most prolific years were 2008 and 2009, each had 11 articles published. With regard to country and region of origin, most articles were from the United States (58). The most cited article was published in Spine in 2000 by Fairbank and Pynsent, who discussed the role of the Oswestry Disability Index as an evaluation standard in spinal disorders, including LSS.

CONCLUSION

The current study analyzed the 100 most cited articles on LSS. It no doubt developed a useful resource with detailed information for many, particularly orthopedic and neurosurgery physicians who want to assimilate research focus and advance of LSS within a relatively short period. Researchers may benefit from emphasis on citation count while citing and evaluating articles and realize the deficiencies when high-level articles appear.

Global Trends of Researches on Lumbar Spinal Stenosis: A Bibliometric and Visualization Study

STUDY DESIGN

Bibliometric and visualization analysis.

OBJECTIVE

Lumbar spinal stenosis (LSS) has become a common health problem and the most frequent indication for spinal surgery. This study aimed to illustrate the overall knowledge structure, and development trends of LSS, using a bibliometric analysis and newly developed visualization tools.

MATERIALS AND METHODS

Research data sets were acquired from the Web of Science. The time span was defined as "2000-2019". VOS viewer and Citespace software was provided to analyze the data and generate visualization knowledge maps. Annual trend of publications, distribution, H-index status, co-authorship status and research hotspots were analyzed.

RESULTS

A total of 1934 publications met the requirement. The United States published most papers (521, 26.9%), both total citations (17,626) and H-index (61) ranked first of all the countries. The most productive organizations on LSS is Seoul National University (50). Spine (43) published the most papers on LSS. Quality of life, risk factor, disability, double blind trials, and decompression surgery are the research hotspots in the recent years.

CONCLUSION

The number of publications showed an upward trend with a stable rise in recent years. The United States is a country with the highest productivity, not only in quality, but also in quantity. Seoul National University has been the largest contributor in this field. Spine is the best journal related to LSS. Quality of life, risk factor, disability, and decompression surgery are the research hotspots in the recent years. Indeed, this study provides a new insight to the growth and development of LSS. Moreover, it will contribute to the growth of the international frontier of LSS.

Characteristics and Trends of Highly Cited Articles in Calcaneus Fracture Research

Background:

Despite significant effort expended toward exploring fracture patterns, surgical timing, surgical approaches, and possible implants within the calcaneus fracture literature, treatment is still fraught with complications and controversy. This study aims to conduct a citation analysis of the most cited articles related to calcaneus fractures to highlight the most historically influential articles, as well as the more recent breakthrough articles that are leading change within the field.

Methods:

A literature search was performed via Scopus on September 20, 2021 using the terms “(calcaneus OR calcaneal OR hindfoot) AND (fracture OR injury)” to search “article title, abstract, and keywords” of all primary and review articles. Search results were rigorously reviewed to ensure appropriateness for this study. The 50 highest total cited included articles were analyzed. Title, authors, journal, country of origin, institution, year of publication, citation variables (total citation count, total citation density, citation count from the last 5 years, and 5-year citation density), and level of evidence were collected for each article. One-way analysis of variance with post hoc testing was used to identify differences in citation variables and level of evidence. Pearson correlation was used to directly compare different citation variables.

Results:

The total citation count average was 178±33, with a total citation density average of 9±2. The year of publication for the 50 articles ranged from 1948 to 2014, with a median year of 1999. Roy W. Sanders was the most productive author in the field, authoring 6 articles and lead authoring 3. The most frequent level of evidence was IV with 19 articles. There was a strong correlation between total citation density and 5-year citation density. The article level of evidence showed no impact on the included measures of an article’s influence.

Conclusion:

This study successfully analyzes and presents the characteristics among the highest cited articles related to calcaneus fractures. The provided characterization of influential works and authors highlights trends, impactful findings, and future areas of focus within calcaneus fracture literature.

Level of Evidence: Review Article.

A Bibliometric Analysis of Intraoperative Neuromonitoring in Spine Surgery

Intraoperative neuromonitoring (IONM) techniques are usually implemented during spine surgery to avoid nefarious abuse of the nervous system, which can cause postoperative problems. A lack of bibliometric analysis on the topic of IONM in spine surgery has been identified. Therefore, the aims of this study are to provide information about the main contributors to this field and their publication dynamics, as well as conceptual and cooperative networks. Results have shown that a steady publication increase has been occurring since 1991, with high levels of citations in the first decade, but irregular publication rates have been recorded more recently. Research production by country seems to be in line with what is observed in other surgical fields, but research funding for IONM in spine surgery seems to be lower, even with the clear interest of private funding agencies. The conceptual networks have shown the importance of motor-evoked potential, electromyography, and the effect of anesthesia, particularly in scoliosis surgery.

A seat at the table: an invitation to the SRS podium via the study group

PURPOSE

The SRS annual meeting (SRS-AM) represents the pinnacle of research in the field of spinal deformity. Spine surgery research was historically based on single-surgeon experience, but an increasing number of abstracts presented at SRS-AM are conducted by multicenter study groups, which may have improved the quality of literature available to surgeons. We sought to determine the proportion of SRS-AM podium presentations (PP) resulting from study groups over a 15-year period.

METHODS

1874 PP from the 2005-2019 SRS-AM were reviewed to determine if they resulted from a study group or multicenter collaboration. Abstracts were also classified as pediatric- or adult-focused. Pearson correlations were calculated to analyze changes in the proportion of study group or multicenter PP.

RESULTS

The number of SRS PP increased from 102 to 171 from 2005 to 2019. 381 (20.3%) PP were identified as a study group product, while 536 (28.6%) resulted from multicenter collaboration. The proportion of study group PP increased by 0.9% annually from 8.8 to 26.9% (r² = 0.44, p = 0.007), while multicenter PP increased by 1.2% annually from 11.8 to 40.9% (r² = 0.51, p = 0.003). A greater proportion of study group PP were level of evidence I or II studies compared to those not resulting from the work of study groups (53.8 vs 19.3%, p < 0.001).

CONCLUSION

SRS-AM PP resulting from research study groups and multicenter collaborations increased over threefold from 2005 to 2019. Spine surgeons are taking a more proactive approach to produce more generalizable research with higher level of evidence through multicenter study groups, allowing them to make more informed decisions to ultimately improve surgical outcomes for patients.

LEVEL OF EVIDENCE

V.

Characteristics and Trends of the Most Cited Spine Publications

STUDY DESIGN

Bibliometric literature review.

OBJECTIVE

The aim of this study was to recognize and analyze the most frequently cited manuscripts published in the journal Spine.

SUMMARY OF BACKGROUND DATA

Although the journal Spine is considered a premiere location for distributing influential spine research, no previous study has evaluated which of their publications have had the most impact. Knowledge and appreciation of the most influential Spine publications can guide and inspire future research endeavors.

METHODS

Using the Scopus database, the 100 most cited articles published in Spine were accessed. The frequency of citations, year of publication, country of origin, level-of-evidence (LOE), article type, and contributing authors/institutions were recorded. The 10 most cited articles (per year) from the past decade were also determined.

RESULTS

"Guidelines For The Process Of Cross-Cultural Adaptation Of Self-Report Measures" by Beaton DE was the most cited article with 2960 citations. 2000 to 2009 (n = 46) was the most productive period. A LOE of III (n = 35) followed by II (n = 34) were the most common. Deyo RA (n = 8), Bombardier C (n = 6), and Waddell G (n = 6) produced the most articles. University of Washington (n = 8) and University of Toronto (n = 8) ranked first for institutional output. Clinical Outcome (n = 28) was the most recurring article topic. The United States (n = 51) ranked first for country of origin.

CONCLUSION

Using citation analysis as an objective proxy for influence, certain publications can be distinguished from others due to their lasting impact and recognition from peers. Of the top cited Spine publications, many pertained to clinical outcomes (28%) and had a LOE of I, II, or III (60%). Although older publications have had longer time to accrue citations, those in the most recent decade comprise this list almost 2:1. Knowledge of these "classic" publications allows for a better overall understanding of the diagnosis, management, and future direction of spine health care.Level of Evidence: 3.

Systematic review of intervertebral disc repair: a bibliometric analysis of the 100 most-cited articles

Study design

A bibliometric review of the literature.

Objective

To identify the most frequently cited articles relating to the repair of intervertebral disc (IVD) and to summarize the key points and findings of these highly cited works, to quantify their impact on the developments of the disc disease treatment.

Summary of background data

IVD repair is an ever-growing and multi-disciplinary innovating treatment method for disc diseases. There are numerous literatures and related studies about it, promoting the development of the field. A comprehensive review and analysis of the most influential articles can help clarify the most effective strategy of IVD repair, and discover the promising directions for future research.

Methods

The Thomson Reuters Web of Knowledge was searched for citations of all literatures relevant to IVD repair. The number of citations, key points, categories, authorships, years, journals, countries, and institutions of publications were analyzed.

Results

The most highly cited articles in IVD Repair were published over 30 years, between 1991 and 2017. Most works (No. 41) were published between 2005 and 2009. The most-cited article was Sakai’s 2003 article which described the possibility of combining MSC and gel to repair IVD. The three most popular categories involved were Orthopedics [44], Clinical Neurology [34], Engineering, and Biomedical [24]. The three most common topics were regenerative medicine and the progenitor cells [33], biomaterials and cellular scaffolds [29], application of growth factors [25]. Author Masuda and the partners have 4 articles in the top 100 list. The Rush University has 12 articles in the top 100 list.

Conclusion

This report identifies the top 100 articles in IVD repair and acknowledges those individuals who have contributed the most to the study of the IVD repair and the body of knowledge used to the repair strategy making. It allows insight into the trends of this innovative and interdisciplinary subspecialty of spine surgery.

High Rate of Studies with Level 1 and 2 Evidence among the 100 Most Cited Articles in Lumbar Spinal Stenosis

BACKGROUND

 To date, no study has used bibliometric analysis to review the most influential articles in lumbar spinal stenosis. The objective of this study was to identify and analyze the characteristics and the level of evidence of the 100 most cited articles on lumbar spinal stenosis METHODS:  The Thomson Reuters Web of Science was accessed to find the 100 most cited articles on lumbar spinal stenosis. For each article, we recorded the number and density of citations, authors, country, journals and years, department, level of evidence, type of study, and if it was part of any multicenter studies.

RESULTS

 Until January 2017, the 100 most cited articles accumulated 11,136 citations (average: 259.05/y), ranging individually between 442 and 50 (average: 111.36). The first reference was published in 1974 in Clinical Orthopaedics and Related Research. Therapeutic studies (n = 40), the 1990s (n = 46), United States as country of origin (n = 51), Harvard University as institution (n = 16), Katz JN as author (n = 10), and Spine as journal (n = 48) have the hegemony. Many were multicenter (n = 42) and using level 2 evidence (n = 49). There is an inverse relationship between citation index and long-standing studies, maintenance of those most cited, and a temporary advance toward better levels of evidence.

CONCLUSION

 This bibliometric analysis reveals a good level of evidence in the published clinical series and includes 100 articles useful for the approach of lumbar spinal stenosis.

Publication rate of abstracts presented at the annual meetings of the AANS/CNS Section on Disorders of the Spine and Peripheral Nerves

OBJECTIVE

The objective of this study was to determine the publication rate of abstracts presented at the annual meetings of the AANS/CNS Section on Disorders of the Spine and Peripheral Nerves (Spine Summit).

METHODS

The authors used a search algorithm in PubMed to determine the publication rate of abstracts presented at the Spine Summit from 2007 to 2012. The variables assessed were presentation modality, topic, meeting year, publication year, destiny journal and its 5-year impact factor (IF), country, and citation count (retrieved from the Scopus database).

RESULTS

One thousand four hundred thirty-six abstracts were analyzed; 502 were oral presentations and 934 were digital poster presentations. The publication rate was 53.97% (775/1436). The mean time from presentation to publication was 1.35 ± 1.97 years (95% CI 1.21-1.49 years). The mean citation count of published articles was 40.55 ± 55.21 (95% CI 36.66-44.44). Oral presentations had a higher publication rate (71.51%, 359/502) than digital posters (44.54%, 416/934; OR 3.13, 95% CI 2.48-3.95, p < 0.001). Oral presentations had a higher number of citations (55.51 ± 69.00, 95% CI 48.35-62.67) than digital posters (27.64 ± 34.88, 95% CI 24.28-31.00, p < 0.001). The mean IF of published articles was 3.48 ± 2.91 (95% CI 3.27-3.70). JNS: Spine (191/775, 24.64%), Spine (103/775, 13.29%), and Neurosurgery (56/775, 7.23%) had the greatest number of published articles. The US represented the highest number of published articles (616/775, 79.48%).

CONCLUSIONS

The publication rate of the Spine Summit is among the highest compared to other spine meetings. Many of the abstracts initially presented at the meeting are further published in high-IF journals and had a high citation count. Therefore, the Spine Summit maintains its high standards of scientific papers, which reflects the high quality of the research performed in the spine surgery field in North America.

Most Cited Articles in Head and Neck Oncology

OBJECTIVES

The number of citations an article receives is an important indication of its impact. The main objectives of this investigation provide readers with a practical guide in evaluating head and neck oncology literature and determine the characteristics of trends in ORL.

METHODS

This was a retrospective bibliometric analysis that did not involve human participant. The Thomson Reuters Web of Science was searched to determine the citations of all published HNO articles. Most cited 300 article analyzed and a total of 100 articles were included in our investigation under the topic search "Head AND NECK AND (cancer OR carcinoma OR oncology)." Articles include malignancies other than head and neck are excluded. The top 100 cited articles were selected and analyzed by 2 independent investigators. Country, Institution, First Author, Journal name, study design, cites per year information gathered and analyzed.

RESULTS

The journal with the highest number of top 100 cited articles was New England Journal Of Medicine with 19 paper, followed by The Journal of Clinical Oncology(17) and Cancer Research (12). The top article on the list (Radiotherapy plus cetuximab for squamous cell carcinoma of the head and neck-NEJM) has 2243 citations. A statistically significant association was found between the journal impact factor and the number of top 100 cited articles (P < .05). The United States had the highest number of articles (63). John Hopkins is differed from other institutions with 15 contributing articles.

CONCLUSION

Our analysis provides an insight into the citation frequency of top cited articles published in HNO to help recognize the quality of the works, discoveries and the trends steering the study of HNO. This is also a modern reading list for young HNO scientist.

Top 100 Cited Articles on Lumbar Spondylolisthesis: A Bibliographic Analysis

STUDY DESIGN

Bibliographic analysis.

OBJECTIVE

The aim of this study is to identify the most cited studies on lumbar spondylolisthesis and report their impact in spine field.

METHODS

Thomson Reuters Web of Science-Science Citation Index Expanded was searched using title-specific search "spondylolisthesis." All studies published in English language between 1900 and 2019 were included with no restrictions. The top 100 cited articles were identified using "Times cited" arranging articles from high to low according to citation count. Further analysis was made to obtain the following items: article title, author's name and specialty, country of origin, institution, journal of publication, year of publication, citations number, study design.

RESULTS

The citation count of the top 100 articles ranged from 68 to 589. All published between 1932 and 2016. Among 20 journals, Spine had the highest number of articles (49), with citation number of 6155 out of 13 618. Second ranked was Journal of Bone and Joint Surgery with 15 articles and total citations of 3023. With regard to the primary author's specialty, orthopedic surgeons contributed to the majority of top 100 list with 82 articles, and neurosurgery was the second specialty with 11 articles. The United States had produced more than half of the list with 59 articles. England was the second country with 7 articles. Surgical management of degenerative lumbar spondylolisthesis was the most common discussed topic.

CONCLUSION

This article identifies the top 100 influential articles on lumbar spondylolisthesis and recognizes an important aspect of knowledge evolution served by leading researchers as they guided today's clinical decision making in spondylolisthesis.

Citation analysis of the highest-cited articles on developmental dysplasia of the hip

The purpose of this study is to determine the highest-cited articles on developmental dysplasia of the hip (DDH) and analyze their bibliometric characteristics. We searched the Web of Science (WoS) for articles with the highest number of citations on DDH and recorded their number of citations in WoS, Scopus, and Google Scholar (GS). We ranked and selected the top 100 cited articles. The average number of citations in WoS was 148 (range 66-638). The most-cited article in all databases was Crowe's total hip replacement cohort on DDH. The Journal of Bone and Joint Surgery American Volume (n = 35) had the most articles in the list, and the United States (n = 46) contributed with the most articles. The University of Bern had the most publications (n = 8). Most studies were therapeutic (n = 45) or diagnostic (n = 29). Hip preservation and arthroplasty investigations have had an increment in citations in recent decades. We provide an historical perspective on research conducted on DDH. A majority of the articles were observational and therapeutic. All databases had good correlation in the number of citations.

Bibliometric Analysis of the 100 Most Cited Articles on Intervertebral Disk Research: From 1900 to 2017 Year

STUDY DESIGN

A bibliometric review of the literature.

OBJECT

To analyze and quantify the most frequently cited papers in intervertebral disk research.

SUMMARY OF BACKGROUND DATA

The number of citations that a paper has received reflects its impact in related research area. In the field of disk research, however, it remains unknown which papers are most cited. By searching related literature databases, we identified the most cited 100 articles that advanced the understanding of the intervertebral disk to provide a historic view of scientific research of the disk.

MATERIALS AND METHODS

Intervertebral disk original research-related publications from January 1, 1900 to December 31, 2017 were retrieved from the Web of Science database. Each retrieved article was analyzed using the Cited Reference Search tool to identify the most cited articles. The number of citations, year of publication, publishing journal, authorship, country of publication, and the knowledge maps of keywords were gathered and generated.

RESULTS

The number of citations of the 100 selected articles ranges from 209 to 1269, and they were published from 1953 to 2009. Basic research is the most common type of study (n=60), followed by epidemiological study (n=40). Spine published 57 of the most cited 100 papers. The greatest contribution came from the United States of America (n=41), followed by the United Kingdom (n=18) and Japan (n=9). Frequently appearing keywords classified into 3 clusters: "biological study," "clinical study," and "imageological study." The keyword "degeneration" was mentioned the most, 51 items, and the word "development" was the latest hot spot in the most cited articles.

CONCLUSIONS

In the field of disk research, some papers were heavily cited more than 100 times, suggesting these studies have substantially contributed to the body of knowledge of the intervertebral disk and findings were widely accepted by related clinicians and scientists.

The impact of the 30 most cited articles on hip arthroscopy: what is the subject matter?

The purpose of this study was to identify the 30 most cited articles on hip arthroscopy and discuss their influence on recent surgical treatment. Due to advancements in hip arthroscopy, there is a widening spectrum of diagnostic and treatment indications. The purpose of this study was to identify the 30 most cited articles on hip arthroscopy and discuss their influence on contemporary surgical treatment. The Thomson Reuters Web of Science was used to identify the 30 most cited studies on hip arthroscopy between 1900 and 2018. These 30 articles generated 6152 citations with an average of 205.07 citations per item. Number of citations ranged from 146 to 461. Twenty-five out of the 30 papers were clinical cohort studies with a level of evidence between III and IV, encompassing 4348 patients. Four studies were reviewed (one including a technical note) and one a case report. We were able to identify the 30 most cited articles in the field of hip arthroscopy. Most articles were reported in high-impact journals, but reported small sample sizes in a retrospective setting. Prospective multi-arm cohort trials or randomized clinical trials represent opportunities for future studies.

Imaging of the Spine: A Bibliometric Analysis of the 100 Most-Cited Articles

STUDY DESIGN

A bibliometric review of the literature.

OBJECTIVE

The aim of this study was to identify the most highly cited articles relating to imaging of the spine and to analyze the most influential papers and evolving trends in spinal imaging research.

SUMMARY OF BACKGROUND DATA

Spinal imaging is being performed with increasing frequency and is an essential step in the diagnosis and treatment planning of spinal pathology. A comprehensive review of the most influential articles in spinal imaging has not been performed, until now.

METHODS

A selection of search terms and keywords were inputted into the "Web of Science" database and the most highly cited articles in spinal imaging were selected from high impact factor journals. The top 100 articles were analyzed for year of publication, authorship, publishing journals, institution and country of origin, subject matter, article type, and level of evidence. In addition to total citation count, the number of annual citations was also calculated. Citation counts from Scopus and Google Scholar were also obtained for comparison across other citation index platforms.

RESULTS

The most highly cited articles in spinal imaging were published over 30 years, between 1983 and 2013. Total citation count ranged from 98 to 1243 with annual citation count ranging from 3.8 to 91.8. The greatest number of highly cited articles was produced in the United States (n = 49), involved magnetic resonance (n = 73) or multimodal (n = 17) imaging and focused on the lumbar spine (n = 42). The journals that contributed the most articles were Spine and Radiology each publishing 26 articles.

CONCLUSION

Our study provided an extensive list of the most historically significant spinal imaging articles, acknowledging the key contributions made to the advancement of this specialist field.

LEVEL OF EVIDENCE

5.

Assessing publication rate of abstracts presented in spine conferences as a quality benchmark: the example of the Canadian Spine Society Annual Meetings

INTRODUCTION

Publication rate can indirectly assess the quality of research presented in scientific meetings. Considering presentations at orthopedic surgery and neurosurgery meetings, 10.5-66% of abstracts are published in scientific journals. Publication rate of abstracts presented at CSS Meetings is unknown. The objective of this study was to evaluate the publication rate of abstracts presented at the Canadian Spine Society(CSS) Annual Meetings from 2005to2014.

METHODS

In October2018, a systematic PubMed search was performed using title and authors of all abstracts presented at CSS Meetings from 2005 to 2014. The following information was retrieved from the articles and abstracts: year, type of presentation, publication in PubMed, time from presentation to final publication, journal and its impact factor(IF).

RESULTS

A total of 621 abstracts were presented at CSS meetings from 2005 to 2014. Publication rate in PubMed was 54.8%(N=340/621). Oral presentations were more likely to be published than poster presentations(63.8%vs44.0%; OR=1.45; CI95%=1.20-1.75; P<0.0001). The mean time from presentation to publication was 1.76 years(±1.93). The 340 identified articles were published in 87 different journals. Most common journals were Spine(N=75; 22.1%), The Spine Journal(N=40;11.8%), and Journal of Neurosurgery:Spine(N=28;8.2%). IF ranged from 0.18 to 47.66(mean=3.73±4.68). IF of articles presented orally were higher than those presented as poster(P=0.038).

CONCLUSIONS

The CSS scientific meeting maintain along the years a steady high quality research presentations as manifested by its significant publication rate(54.8%) in medical journals with mean IF of 3.73. In comparison with other spine scientific meetings, publication rates of abstracts presented at CSS meeting is amongst the highest.

The 100 most influential spine fracture publications

Background

Management of spine fractures has advanced considerably even over the past decade. A review of the current and historical literature can lead to a better appreciation of current management protocols. This is the first comprehensive review of the most influential articles related to spine fracture management. The purpose of this study is to identify and analyze the 100 most cited publications in spine fracture management.

Methods

Using the Clarivate Analytics Web of Science, search phrases were used to identify publications pertaining to spine fractures (110,809 publications). The 100 most cited articles were isolated. The frequency of citations, year of publication, country of origin, journal of publication, level-of-evidence (LOE), article type, and contributing authors/institutions were recorded. We also highlighted the ten most cited articles (per year) from the past decade.

Results

The publications included ranged from 1953-2010, with the majority published between 2000-2009 (n=41). Total citations ranged from 154 to 1,076. A LOE of IV had the plurality at 36%. The most cited article was "The 3 Column Spine and Its Significance in The Classification of Acute Thoracolumbar Spinal-Injuries" (Spine 1983) by F Denis. The majority of papers originated in the United States (n=65), and the highest number were published in Spine (n=27). Osteoporotic fractures were the specific topic in 34 publications. In the past decade, the article with the most citations/year was "A Randomized Trial of Vertebroplasty for Osteoporotic Spinal Fractures" by DF Kalmes in 2009.

Conclusions

Despite less time for citation than other decades, the 2000s contain the plurality of the influential publications. This may indicate that some of the most important changes to spine fracture management pertain to improved imaging modalities and surgical technologies. This review provides a guide for a comprehensive understanding of the historical and current literature pertaining to spine fracture management.

Citation analysis of the most influential articles on traumatic spinal cord injury

Objective: We conducted a citation analysis in order to catalog and pay tribute to the 100 most influential clinical research articles in traumatic spinal cord injury.Design: The Thomson Reuters Web of Science was searched in a two-step process without time period limitations. Review articles were excluded. In the first stage of data extraction, a Boolean query was used to identify the top 100 most cited clinical papers on traumatic spinal cord injury. One hundred and seven keywords were manually chosen and extracted from titles and abstracts. A second Boolean query used these keywords to broaden search results. The top 100 articles from this second stage search comprised the final list.Outcome Measures: For each article, measures evaluated were number of citations, average number of citations per year, time elapsed before first citation, and time elapsed until the year in which each article received its respective highest number of citations in a one-year period.Results: 119,991 articles were found in the second stage search. The top 100 most cited articles meeting inclusion criteria were identified within the first 2,104 results. Archives of Physical Medicine and Rehabilitation was the most represented journal, with 20 of the top 100 articles. The top 100 list averaged 255 citations per article. The most highly cited article was the NASCIS 2 trial by Bracken et al., cited 1500 times, which investigated the efficacy of methylprednisolone or naloxone for spinal cord injury.Conclusion: Clinical research in traumatic spinal cord injury has grown over time, expanding to encompass rehabilitation and experimental therapies in addition to acute management trials. The list may serve as an archive and reference for further studies in this field.

Predominance of Studies With Poor Level of Evidence Among the Top 100 Most Cited Studies on Idiopathic Scoliosis: A Bibliometric and Content Analysis

STUDY DESIGN

Bibliometric review of current literature.

OBJECTIVE

To identify and analyze the characteristics of the 100 most cited articles on idiopathic scoliosis focusing on the level of evidence.

SUMMARY OF BACKGROUND DATA

The scientific literature on idiopathic scoliosis has been constantly evolving, but many aspects of its true etiology, natural history, and response to treatment continue to be discussed. To date, no study has used bibliometric analysis to review the most influential articles about idiopathic scoliosis.

METHODS

The Thompson Reuters Web of Science was accessed to find the 100 most cited articles on idiopathic scoliosis. The number and citation density, authorship, institutions, country of origin, year of publication, source journals, type of study, topic, study design, and level of evidence were analyzed.

RESULTS

The 100 most frequently cited articles accumulated 13,749 citations. The number of citations ranged between 616 and 80. The 10 most cited articles represent 24.6% of all citations. The treatment of idiopathic scoliosis is the most commonly studied issue (n = 46), and specifically surgical correction (n = 36). Most studies originated in the United States (n = 62) and were published in Spine (n = 56). Almost half of the papers (n = 49) were published between 2000 and 2008. The majority of studies have a case series design (n = 35). Most of the cited articles have low levels of evidence (Level III = 36; Level IV = 35).

CONCLUSION

This bibliometric analysis includes the 100 most cited articles on idiopathic scoliosis, recognizing its importance as a basic milestone in today's spine knowledge. The results indicate that the evolution of the knowledge on idiopathic scoliosis has been through case reports and case series, which analyzed retrospectively today are considered to have a poor level of evidence. This observation seems to be paradoxical because they are the most influential articles on IS and had been published in the top, leading journals of spine surgery.

The 100 top-cited publications in psoriatic arthritis: a bibliometric analysis

BACKGROUND

Citation analysis is a quantitative, bibliometric method that analyzes the frequency and pattern of citations in any given scientific discipline. Over the last two decades, the study of psoriatic arthritis has undergone substantial progress, which has enhanced our ability to assess and treat the disease, and yet an updated citation analysis that reflects these advances is lacking.

OBJECTIVE

To highlight the scientific progress in psoriatic arthritis by identifying and analyzing the 100 top-cited psoriatic arthritis articles from the last 40 years.

METHODS

Publications on psoriatic arthritis were identified using the Scopus citation database and Web of Science. No date range limits were applied. Data on the 100 top-cited publications were extracted and analyzed.

RESULTS

Of the 100 top-cited publications, the median number of citations per publication was 265.9. Articles originated from 29 different countries. Publication dates ranged from 1973 to 2014. The majority (n = 88) were published after 1994, and the greatest number of highly cited psoriatic arthritis publications were reported between 2001 and 2007 (n = 36). Journals with the highest number of top-cited articles included Arthritis and Rheumatology (formerly Arthritis and Rheumatism) (n = 26), followed by Annals of Rheumatic Diseases (n = 21) and Journal of Rheumatology (n = 11). The top six journals with the most highly cited psoriatic arthritis articles were rheumatology journals, with the exception of the Journal of American Academy of Dermatology, a dermatology-based periodical. General medical journals published only nine of the 100 top citations. Impact factors ranged from 2.133 to 44.002, with a mean impact factor of 9.103. There were five authors with 10 or more highly cited psoriatic arthritis publications and 30 authors with five or more of the top publications. Subgroup analysis of the top 25 articles included nine randomized clinical trials, nine observational studies, five reviews, and two guideline statements. Additional subgroup analysis identified the top five hallmark trials in the field. Key publications provided data on classification criteria, disease prevalence, patterns of clinical and radiographic presentation, disease outcomes, associated cardiovascular disease risk, immunologic features and HLA associations, and efficacy and therapeutic benefit of TNFα inihbitors, interleukin-12/23 antagonists, and sulfasalazine.

CONCLUSIONS

The study of psoriatic arthritis is rapidly evolving. This bibliometric analysis delineates the landmark publications in psoriatic arthritis that have defined innovative therapeutic modalities and provided critical reviews, guidelines, and other key studies, which highlight the important progress made in the field.

Uninstrumented Posterior Lumbar Interbody Fusion: Have Technological Advances in Stabilizing the Lumbar Spine Truly Improved Outcomes?

BACKGROUND

Since the 1980s, numerous operations have replaced posterior lumbar interbody fusion (PLIF) with human bone. These operations often involve expensive implants and complex procedures. Escalating expenditures in lumbar fusion surgery warrant re-evaluation of classical PLIF with allogeneic ilium and without instrumentation. The purpose of this study was to determine the long-term fusion rate and clinical outcomes of PLIF with allogeneic bone (allo-PLIF).

METHODS

Between 1981 and 2006, 321 patients aged 12-80 years underwent 339 1-level or 2-level allo-PLIFs for degenerative instability and were followed for 1-28 years. Fusion status was determined by radiographs and as available, by computed tomography scans. Clinical outcome was assessed by the Economic/Functional Outcome Scale.

RESULTS

Of the 321 patients, 308 were followed postoperatively (average 6.7 years) and 297 (96%) fused. Fusion rates were lower for patients with substance abuse (89%, P = 0.007). Clinical outcomes in 87% of patients were excellent (52%) or good (35%). Economic/Functional Outcome Scale scores after initial allo-PLIF on average increased 5.2 points. Successful fusion correlated with nearly a 2-point gain in outcome score (P = 0.001). A positive association between a patient characteristic and outcome was observed only with age 65 years and greater, whereas negative associations in clinical outcomes were observed with mental illness, substance abuse, heavy stress to the low back, or industrial injuries. The total complication rate was 7%.

CONCLUSIONS

With 3 decades of follow-up, we found that successful clinical outcomes are highly correlated with solid fusion using only allogeneic iliac bone.

Bibliometric analysis of the top-cited articles on islet transplantation

AIMS

To identify and characterize the top-cited articles in the field of islet transplantation.

METHODS

We used the Science Citation Index Expanded database to identify the most frequently cited articles published after 1900. Articles were evaluated using the following characteristics: citation number, publication year, study design, references, country and institution of origin, authorship, and journal. Keyword analysis and citation networks were used to analyze research trends.

RESULTS

The most frequently cited articles received between 146 and 2988 citations; the median was 291. All of the most frequently cited articles were published between 1972 and 2012, and 85 articles were published after 1990. The most popular study design involved basic science (75 articles). The leading countries were the United States (US) and Canada, and the leading institutions were the University of Alberta, Canada, and the University of Minnesota, in the US. Journals specializing in diabetes or transplantation published more than half of the articles (n = 53, 52%), with the journal Diabetes publishing the largest number (n = 30). No association was found between a journal's impact factor and the number of top-cited articles it published. There was no correlation between the number of citations and the number of years since publication, authors, participating institutions, or countries involved. Top-cited articles focused on 2 themes: the use of antirejection immunotherapy or biocompatible encapsulations to prolong graft survival, and assessments of the efficacy of islet transplants, in particular, islet allografts.

CONCLUSIONS

Our study can help researchers to identify and decipher the characteristics of top-cited articles in the field of islet transplantation. Just as clinically successful allografts are carried out using the Edmonton protocol, autografts and xenografts should be similarly strengthened to solve problems relating to immune rejection and islet sources, respectively.

The top 100 papers in dry eye - A bibliometric analysis

PURPOSE

Citation analysis represents one of the best currently available methods for quantifying the impact of articles. Bibliometric studies list the ''best sellers'' in a single field of interest. The purpose of the present study was to identify and analyze the most frequently cited papers in dry eye research that may be of high interest for researchers and clinicians.

METHODS

We reviewed the database of the Institute for Scientific Information to identify articles published from 1900 to September 2016. All dry eye articles published in 59 ophthalmology journals were identified. The top 100 articles were selected for further analysis of authorship, source journal, number of citations, citation rate, geographic origin, article type, and level of evidence.

RESULTS

The 100 most-cited articles were published between 1983 and 2011, with most of them in the 2000s. The number of citations per article ranged from 96 to 610, and was greatest for articles published in the 2000s. Each of these articles was published in one of 15 journals. Most articles represented Level-III evidence, followed by Levels II and I.

CONCLUSIONS

The present study focusing on dry eye research revealed that 55% of the most-cited articles came from the U.S. and 18% from Japan. Diagnostics and therapy were the areas of focus of most of the clinical articles; 13% of the most cited papers were review articles. This analysis provides researchers and clinicians with a detailed overview on the most cited dry eye papers over the past decades.

Top 50 cited journal articles on overhead throwing athletes: a bibliographic analysis

Background

The frequency of citations for a journal article is a reflection of its academic impact. The purpose of this study was to identify and characterize the top 50 cited journal articles related to overhead throwing athletes in the published literature.

Methods

The Web of Science database was searched on January 18, 2016, using the terms "throwing athlete," "baseball," and "pitcher" to identify the top 50 cited articles related to overhead throwing athletes using the all-database function. The type of study, country of origin, publishing journal, and year published were reviewed for each article.

Results

The top 50 articles identified were cited between 95 and 471 times and were published in 13 journals between 1969 and 2011. Most of the articles were small case series or nonsystematic literature reviews. The shoulder was the most common body region studied in the top 50 articles (33 of 50 [66%]). Among original studies (n = 43), there was a good representation of surgical management of shoulder and elbow pathology in overhead athletes (9 of 43 [20.9%]); however, most of the articles reported on shoulder and elbow kinematics (19 of 43 [44.2%]) and pathoanatomy (15 of 43 [34.9%]).

Conclusion

The greater prevalence of nonsurgical articles may reflect a continued effort to better understand the different pathologies specific to overhead throwing athletes. An understanding of the variable content and quality of frequently cited articles on overhead throwing athletes may serve as a stepping stone for future studies to advance the diagnosis and management of complex elbow and shoulder injuries in these high functional individuals.

Most Cited Publications in Cervical Spine Surgery

PURPOSE

The purpose of this study is to perform a citation analysis on the most frequently cited articles in the topic of cervical spine surgery and report on the top 100 most cited publication in this topic.

METHODS

We used the Thomson Reuters Web of Science to search citations of all articles from 1945 to 2015 relevant to cervical spine surgery and ranked them according to the number of citations. The 100 most cited articles that matched the search criteria were further analyzed by number of citations, first author, journal, year of publication, country and institution of origin.

RESULTS

The top 100 cited articles in the topic of cervical spine surgery were published from 1952-2011. The number of citations ranged from 106 times for the 100th paper to 1206 times for the top paper. The decade of 1990-1999 saw the most publications. The Journal of Spine published the most articles, followed by Journal of Bone and Joint Surgery America. Investigators from America authored the most papers and The University of California contributed the most publications. Cervical spine fusion was the most common topic published with 36 papers, followed by surgical technique and trauma.

CONCLUSION

This article identifies the 100 most cited articles in cervical spine surgery. It has provided insight to the history and development in cervical spine surgery and many of which have shaped the way we practice today.

Study-protocol for a randomized controlled trial comparing clinical and radiological results after three different posterior decompression techniques for lumbar spinal stenosis: the Spinal Stenosis Trial (SST) (part of the NORDSTEN Study)

Background

There are several posterior decompression techniques for lumbar spinal stenosis (LSS). There is a trend towards performing less invasive surgical procedures, but no multicentre randomized controlled trials have evaluated the relative efficacy of these techniques at short and long-term.

Method/design

A multicentre randomized controlled trial [the Spinal Stenosis Trial (SST) (part of the NORDSTEN study)] including 465 patients aged 18–80 years with neurogenic claudication or radiating pain and MRI findings indicating lumbar spinal stenosis without spondylolisthesis is performed to compare three posterior decompression techniques: unilateral laminotomy with crossover, bilateral laminotomy and spinous process osteotomy. The primary outcome is change in Oswestry Disability Index (ODI 2 years postoperatively). Secondary outcomes are change in EQ-5D, Zurich Claudication Questionnaire, and Numeric Rating Scale for leg-pain and back-pain. Also recorded were Global Perceived Effect score, complications, length of hospital stay, reoperation rate 2 years postoperatively, difference in recurrence of symptoms or postoperative instability, and MRI change in the dural sac area. Further, a 5 and 10 years follow-up is planned with the same outcome measures.

Discussion

Newer and less invasive techniques are increasingly favoured in surgery for LSS. This trial will compare the clinical and radiological results of three different techniques, and may contribute to better clinical decision making in the surgical treatment of LSS.

Trial registration

ClinicalTrials.gov reference: NCT02007083 (November 22, 2013).

100 Most Influential Publications in Scoliosis Surgery

STUDY DESIGN

Bibliometric analysis.

OBJECTIVE

To apply the established technique of citation analysis to identify the 100 most influential articles in scoliosis surgery research published between 1900 and 2015.

SUMMARY OF BACKGROUND DATA

Previous studies have applied the technique of citation analysis to other areas of study. This is the first article to apply this technique to the field of scoliosis surgery.

METHODS

A two-step search of the Thomson Reuters Web of Science was conducted to identify all articles relevant to the field of scoliosis surgery. The top 100 articles with the most citations were identified based on analysis of titles and abstracts. Further statistical analysis was conducted to determine whether measures of author reputation and overall publication influence affected the rate at which publications were recognized and incorporated by other researchers in the field.

RESULTS

Total citations for the final 100 publications included in the list ranged from 82 to 509. The period for publication ranged from 1954 to 2010. Most studies were published in the journal Spine (n = 63). The most frequently published topics of study were surgical techniques (n = 35) and outcomes (n = 35). Measures of author reputation (number of total studies in the top 100, number of first-author studies in the top 100) were found to have no effect on the rate at which studies were adopted by other researchers (number of years until first citation, and number of years until maximum citations). The number of citations/year a publication received was found to be negatively correlated with the rate at which it was adopted by other researchers, indicating that more influential manuscripts attained more rapid recognition by the scientific community at large.

CONCLUSION

In assembling this publication, we have strived to identify and recognize the 100 most influential articles in scoliosis surgery research from 1900 to 2015.

LEVEL OF EVIDENCE

N/A.

Intravenous Lipid Emulsion as an Antidote for the Treatment of Acute Poisoning: A Bibliometric Analysis of Human and Animal Studies

In recent years, there has been increasing interest in the role of intravenous lipid formulations as potential antidotes in patients with severe cardiotoxicity caused by drug toxicity. The aim of this study was to conduct a comprehensive bibliometric analysis of all human and animal studies featuring lipid emulsion as an antidote for the treatment of acute poisoning. The Scopus database search was performed on 5 February 2016 to analyse the research output related to intravenous lipid emulsion as an antidote for the treatment of acute poisoning. Research indicators used for analysis included total number of articles, date (year) of publication, total citations, value of the h-index, document types, countries of publication, journal names, collaboration patterns and institutions. A total of 594 articles were retrieved from Scopus database for the period of 1955-2015. The percentage share of global intravenous lipid emulsion research output showed that research output was 85.86% in 2006-2015 with yearly average growth in this field of 51 articles per year. The USA, United Kingdom (UK), France, Canada, New Zealand, Germany, Australia, China, Turkey and Japan accounted for 449 (75.6%) of all the publications. The total number of citations for all documents was 9,333, with an average of 15.7 citations per document. The h-index of the retrieved documents for lipid emulsion research as antidote for the treatment of acute poisoning was 49. The USA and the UK achieved the highest h-indices, 34 and 14, respectively. New Zealand produced the greatest number of documents with international collaboration (51.9%) followed by Australia (50%) and Canada (41.4%) out of the total number of publications for each country. In summary, we found an increase in the number of publications in the field of lipid emulsion after 2006. The results of this study demonstrate that the majority of publications in the field of lipid emulsion were published by high-income countries. Researchers from institutions in the USA led scientific production on lipid emulsion research. There is an obvious need to promote a deeper engagement through international collaborative research projects and funding mechanisms.

The 100 Most Influential Publications in Cervical Spine Research

STUDY DESIGN

Bibliometric study of current literature.

OBJECTIVE

To identify and analyze the 100 most cited publications in cervical spine research.

SUMMARY OF BACKGROUND DATA

The cervical spine is a dynamic field of research with many advances made within the last century. The literature has, however, never been comprehensively analyzed to identify and compare the most influential articles as measured by the number of citations.

METHODS

All databases of the Thomson Reuters Web of Knowledge were utilized in a two-step approach. First, the 150 most cited cervical spine studies up to and including 2014 were identified using four keywords. Second, all keywords related to the cervical spine found in the 150 studies (n = 38) were used to conduct a second search of the database. The top 100 most cited articles were hereby selected for further analysis of current and past citations, authorship, geographic origin, article type, and level of evidence.

RESULTS

Total citations for the 100 studies identified ranged from 173 to 879. They were published in the time frame 1952 to 2008 in a total of 30 different journals. Most studies (n = 42) were published in the decade 1991-2000. Level of evidence ranged from 1 to 5 with 39 studies in the level 4 category. A total of 13 researchers were first author more than once and nine researchers senior author more than once. The two-step approach with a secondary widening of search terms yielded an additional 27 studies, including the first ranking article.

CONCLUSION

This bibliometric study is likely to include some of the most important milestones in the field of cervical spine research of the last 100 years.

The 100 most-cited articles in spinal oncology

OBJECTIVE The authors' objective was to identify the 100 most-cited research articles in the field of spinal oncology. METHODS The Thomson Reuters Web of Science service was queried for the years 1864-2015 without language restrictions. Articles were sorted in descending order of the number of times they were cited by other studies, and all titles and abstracts were screened to identify the research areas of the top 100 articles. Levels of evidence were assigned on the basis of the North American Spine Society criteria. RESULTS The authors identified the 100 most-cited articles in spinal oncology, which collectively had been cited 20,771 times at the time of this writing. The oldest article on this top 100 list had been published in 1931, and the most recent in 2008; the most prolific decade was the 1990s, with 34 articles on this list having been published during that period. There were 4 studies with Level I evidence, 3 with Level II evidence, 9 with Level III evidence, 70 with Level IV evidence, and 2 with Level V evidence; levels of evidence were not assigned to 12 studies because they were not on therapeutic, prognostic, or diagnostic topics. Thirty-one unique journals contributed to the 100 articles, with the Journal of Neurosurgery contributing most of the articles (n = 25). The specialties covered included neurosurgery, orthopedic surgery, neurology, radiation oncology, and pathology. Sixty-seven articles reported clinical outcomes. The most common country of article origin was the United States (n = 62), followed by Canada (n = 8) and France (n = 7). The most common topics were spinal metastases (n = 35), intramedullary tumors (n = 18), chordoma (n = 17), intradural tumors (n = 7), vertebroplasty/kyphoplasty (n = 7), primary bone tumors (n = 6), and others (n = 10). One researcher had authored 6 studies on the top 100 list, and 7 authors had 3 studies each on this list. CONCLUSIONS This study identified the 100 most-cited research articles in the area of spinal oncology. The studies highlighted the multidisciplinary and multimodal nature of spinal tumor management. Recognition of historical articles may guide future spinal oncology research.

A history of spine biomechanics. Focus on 20th century progress

The application of mechanical principles to problems of the spine dates to antiquity. Significant developments related to spinal anatomy and biomechanical behaviour made by Renaissance and post-Renaissance scholars through the end of the 19th century laid a strong foundation for the developments since that time. The objective of this article is to provide a historical overview of spine biomechanics with a focus on the developments in the 20th century. The topics of spine loading, spinal posture and stability, spinal kinematics, spinal injury, and surgical strategies were reviewed.