The 100 most-cited articles on lumbar disc herniation: A bibliometric and network analysis

BackgroundLumbar disc herniation (LDH) generates a large and continuously expanding body of literature. Citation analysis identifies the publications that have most influenced a field, yet no bibliometric study has specifically examined the most-cited articles devoted to LDH as a clinical entity. The aim of this study was to identify and characterize the 100 most-cited articles on lumbar disc herniation.MethodsThe Web of Science Core Collection was searched on a single day using a title-field query combining recognized terms for lumbar disc herniation, restricted to articles and reviews published between 1980 and 2025. The ranked list was screened by one reviewer and independently verified by a second. For each article, the citation count, citation density, publication year, journal, country of origin, document type, authorship, study design, and subject focus were extracted and analyzed descriptively.ResultsThe 100 most-cited articles accumulated 17,179 citations (mean, 171.8; median, 126.5), with individual counts ranging from 91 to 879. They were published between 1980 and 2023, peaking in the 2000s (42 articles). The most-cited article was the randomized Spine Patient Outcomes Research Trial (879 citations), followed by Weber's 10-year controlled prospective study (807 citations). The articles appeared in 41 journals, with Spine dominant (40 articles), followed by European Spine Journal (6) and the Journal of Bone and Joint Surgery-American Volume (5). They originated from 21 countries; the United States led with 28 articles, but the three East Asian countries together contributed 32, collectively exceeding the United States. Original articles comprised 84 of the list and reviews 16. Treatment-oriented studies-surgical technique and outcome together with non-operative and interventional management-predominated.ConclusionsThe literature is dominated by treatment-focused research concentrated in a small number of specialty spine journals and-unlike comparable analyses of other spinal disorders-reflects a notably strong East Asian contribution alongside continued United States leadership.