Global research trends in robot-assisted spinal surgery: a visualized bibliometric analysis

This study aims to systematically analyze the global research trends, knowledge structure, core hotspots, and evolutionary path in the field of robotic-assisted spinal surgery (RASS) using bibliometric methods. It aims to address the gap in existing literature, which lacks a systematic integration of global research dynamics and core themes, and provide data-driven decision support for clinical practice and research layout.

A total of 399 valid articles published between 1997 and 2025 were retrieved and screened from the Web of Science Core Collection. Tools including CiteSpace, VOSviewer, and Excel were employed for quantitative and visual analysis of key indicators, including annual publication count, citation frequency, h-index, and betweenness centrality. Additionally, co-occurrence, clustering, timeline, and burst detection analyses were performed on countries, institutions, authors, journals, keywords, and co-cited articles.

The first article in the RASS field was published in 1997. Before 2017, the annual publication volume remained in single digits, indicating an embryonic stage. After 2017, the field entered a rapid development phase, with an average of 38.7 articles published annually and a peak of 53 articles in 2022. The United States (n = 163, centrality = 1.02) and China (n = 126) were the leading contributors, whereas Germany demonstrated the highest average citation rate per article. Beijing Jishuitan Hospital was the most productive institution (n = 20). Tian Wei was the most prolific author (n = 20), and Theodore N had the highest h-index. World Neurosurgery published the most relevant articles (n = 36), while Spine received the highest number of citations. Core keywords included "accuracy" (19%), "navigation" (11%), and "pedicle screw placement" (10%). Burst detection of keywords such as "robotic-assisted spinal surgery" and "feasibility" highlights current research frontiers. The most cited article was published by DeVito DP in Spine in 2010.

This analysis demonstrates that the RASS field is evolving rapidly, with research leadership concentrated in the United States and China and a primary focus on improving the precision of pedicle screw placement. The identified trends underscore the need for future work to prioritize the deep integration of artificial intelligence into surgical workflows, the development of radiation-free navigation, and comprehensive evaluations of clinical feasibility and cost-effectiveness. These findings provide data-driven guidance for shaping clinical practice and strategic research planning.