Secondary Logo

Institutional members access full text with Ovid®

Highly Cited Works in Spinal Disorders

The Top 100 Most Cited Papers Published in Spine Journals

Badhiwala, Jetan H., MD; Nassiri, Farshad, MD; Witiw, Christopher D., MD, MSc; Mansouri, Alireza, MD, MSc; Alotaibi, Naif, MD, MSc; Eagles, Matthew, MD; Almenawer, Saleh A., MD, MSc; da Costa, Leodante, MD; Wilson, Jefferson R., MD, PhD; Fehlings, Michael G., MD, PhD§

doi: 10.1097/BRS.0000000000002735

Study Design. Bibliometric analysis.

Objective. To identify, and summarize the key findings of, the top 100 most highly cited works published in spinal disorder topic-specific journals.

Summary of Background Data. There is an abundance of published articles pertaining to spine surgery and spinal disorders. The number of citations a work receives provides a useful measure of its scientific impact. An understanding of the most cited works in spine surgery can identify literature that surgeons and researchers should be familiar with, point to the most active areas of research, inform the design of educational curricula, and help guide future research efforts.

Methods. Journals relating to spinal disorders were identified using the Journal Citation Reports database. We then searched the Web of Science database for articles appearing in each of these journals. The top 100 most cited works were selected for analysis.

Results. The top 100 most cited articles appeared in seven of eight journals dedicated to spinal disorders, with 84 in Spine and seven in the European Spine Journal. The citation count for individual articles ranged from 343 to 1949. Most works (73) were published between 1990 and 2004. The greatest number of articles (22) focused on low back pain, followed by biomechanics (13), degenerative disc disease (12), and lumbar spinal stenosis/lumbar fusion (9). With regard to study design, laboratory investigations were the most common (12), followed by guideline documents (11), reviews (10), and retrospective cohort studies (10).

Conclusion. The most cited works in spinal disorder journals are guidelines for low back pain, descriptions of quality of life (QOL) metrics, or laboratory investigations into spinal biomechanics. A gap exists for work relating to neck pain or cervical spinal pathology (e.g., cervical myelopathy), representing opportunity for future work. Time of publication, topic of study, study design, and journal are possible determinants of likelihood of citation.

Level of Evidence: N/A

Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada

Section of Neurosurgery, Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada

Division of Neurosurgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada

§Division of Neurosurgery and Spinal Program, Department of Surgery, Krembil Neuroscience Center, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada.

Address correspondence and reprint requests to Michael G. Fehlings, MD, PhD, FRCSC, Division of Neurosurgery and Spinal Program, Department of Surgery, Krembil Neuroscience Center, Toronto Western Hospital, University of Toronto, 399 Bathurst St., Suite 4W-449, Toronto, ON M5T 2S8, Canada; E-mail:

Received 1 September, 2017

Revised 9 April, 2018

Accepted 11 May, 2018

The manuscript submitted does not contain information about medical device(s)/drug (s).

No funds were received in support of this work.

Relevant financial activities outside the submitted work: grants.

The Supplemental Content is available for this article.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (

Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.