Research Frontiers in Spine Surgery - A Scientometric Analysis of RCTs Published from 1990 to 2019

Introduction: Spine surgery is evolving and in the due course of its evolution, it is often essential to have a comprehensive summary of the process to have a greater understanding in order to refine our future directives. With the multiplying domains of research in the spine, it has become difficult for a surgeon to find the potential hotspots in research or identify the emerging research frontiers. With the technological developments like data mining, graphic drawing, information analytics combined with the computational statistics, visualization of scientific metrology has become a reality. Scientometrics is a quantitative method of analyzing such an evolutionary process through various parameters like citation metrics, keyword and author networks. Scientometrics can visualize this panorama of information through knowledge maps to explore hotspots in research. Hence, we aim to assess the potential research domains of randomized controlled trials (RCTs) for the past three decades (1990-2019) along with their research networks and identify the hot topics for future research. Methodology: A comprehensive and systematic analysis of all the RCTs published on Spine Surgery from 1990-2019 retrieved from the Web of Science Core Collection database. Scientometric and visual analysis of their characteristics, co-operation networks, keywords and citations were made using Cite- Space software. CiteSpace was used to visualize the structure, regularity and distribution of research domains in the spine surgery and analyze the article co-citation data to mine the knowledge clustering and citation space distribution. We also analyzed the co-occurrence between the additional research units such as cooperation among various authors, institutions and countries in the field of spine surgery. Consolidating the results of the analysis we built a comprehensive knowledge map elaborating on the emerging research trend with the potential research domain from RCTs published in spine surgery. Results: A total of 696 RCTs were published in spine surgery from 1990-2019 of which the USA(n = 263) and China(n = 71) made a significant contribution. Thomas Jefferson University(n = 16) was the leading contributor to RCTs in spine surgery. Weinstein JN was the most cited author in the field followed by Deyo RA. Spine(n = 559) remained the top-cited journal among RCTs in spine surgery. On literature co-citation analysis, "spinal stenosis", "anterior cervical discectomy and fusion", "degenerative disc disease" and "minimally invasive decompression" were identified as the hotspots and potential research frontiers. Conclusion: Research cooperation among developed and developing nations remains crucial and needs to be strengthened. It was evident from the identified hotspots that extending the frontiers in the management of degenerative disorders of spine through further research holds the potential for advancement in spinal care.