Bibliometric and visualized analysis of the top 100 most-cited articles on anterior cervical surgery

Anterior cervical surgery (ACS) owes its development to various pioneering individuals whose revolutionary works form key advances and guide current medical decisions. This bibliometric study aimed to identify, analyse and visualize the main features of the most-cited papers in ACS. The citation count for the top 100 most-cited articles ranged from 148 to 1,197, and citations per year ranged from 3.1 to 89.8. The articles were published from 1958 to 2016, with the 2000s being the most active decade. There was an inverse correlation between the average citations per year since publication and article age. The oldest as well as most-cited two articles were both published in 1958 by Smith and Robinson, and Cloward, respectively. In their studies, the authors individually described the technique of anterior cervical discectomy with fusion (ACDF). The most popular keywords were: 'fusion' (22), 'spine' (20), 'cervical spine' (16), 'complications' (15), 'arthrodesis' (13), 'interbody fusion' (13), 'bone morphogenetic protein' (13), and 'radiculopathy' (12). ACDF was the most frequent surgical procedure (80%), while cervical disc arthroplasty is of gradual greater impact. The surgical techniques of ACDF have remained unaltered for over 60 years. More attempts are needed to promote its development. Cite this article: EFORT Open Rev 2021;6:1203-1213. DOI: 10.1302/2058-5241.6.210074.