ABSTRACT
Background: Since entering the 21st century, there has been an increasing interest in minimally invasive surgery for spinal diseases, which has led to the continued development of minimally invasive spine surgery (MISS), with major breakthroughs in technology and technical skills. However, in recent years, there is little relevant research using bibliometrics to analyze the field of MISS research. The purpose of this study is to sort out the publication situation and topic trends of articles in the field of MISS research from the perspective of bibliometrics. Methods: The articles and reviews related to MISS from 2000 to 2022 were retrieved and downloaded from the Web of Science Core Collection (WOSCC). Visualization and knowledge mapping were performed using three bibliometric tools, including online bibliometric platform, CiteSpace and VOSviewer software. Curve fitting and correlation analysis were performed using Microsoft Excel software. The global research publication output, contributions of countries, institutions, authors, and journals, average citations per item (ACI), Hirsch index (H-index), research hot keywords, etc., in this field were analyzed. Results: A total of 2384 papers were retrieved, including 2135 original papers and 249 review papers. In the past 22 years, the number of annual publications of MISS research has shown a steady growth trend. China contributed the most papers, and the United States ranked second, but the United States had the highest total citations, and H-index value. The most prolific institutions were Soochow University, Capital Medical University and Wooridul Spine Hospital. In this field, Professors Lee SH, Ahn Y and Yang HL have made significant achievements. However, there is relatively little international collaboration between institutions or researchers. World Neurosurgery is the most published journal on MISS research. According to the keyword co-occurrence analysis, recent keywords mainly focus on researches on minimally invasive modalities, techniques and prognosis, while on the keyword analysis of the ongoing bursts, percutaneous transforaminal endoscopic discectomy, lumbar diskectomy, spinal stenosis, recompression, diskectomy, endoscopic spine surgery, laminectomy, transforaminal lumbar interbody fusion, etc., will likely continue to be a research hotspot in the near future. Conclusion: Looking at the temporal trend in the number of publications per year, the number of publications for the MISS study will increase in the near future. China has the highest number of publications, but the US has the highest quality publications. International cooperation needs to be further strengthened. Our findings can provide useful information for the academic community and identify possible research fronts and hotspots in the coming years.
ABSTRACT
OBJECTIVE: To explore the clinical efficacy of percutaneous pedicle screw short segment internal fixation with or without the intermediate screw in the treatment of Magerl A3 thoracolumbar fractures with low bone mineral density. METHODS: Patients with Magerl A3 thoracolumbar fracture underwent percutaneous pedicle screw short segment internal fixation from January 2017 to July 2020 were retrospectively analyzed, 93 cases met the diagnosis and inclusion criteria, 9 cases were excluded according to the exclusion criteria, and the remaining 84 cases obtained complete imaging follow-up data. There were 38 males and 46 females, the age ranged from 56 to 73 years old with an average of (64.78±7.12) years old, bone mineral density (BMD) ranged from 0.61 to 0.89 g/cm3 with an average of (0.73±0.14) g/cm3, the follow-up time was 11 to 25 months with an average of (17.58±6.12) months. There were 45 cases in group A with intermediate screw and 39 cases in group B without intermediate screw. The operation time and intraoperative blood loss were recorded, Oswestry Disability Index (ODI) and visual analogue scale (VAS) were used for clinical evaluation. The Cobb angle, vertebral wedge angle (VWA) and anterior vertebral body height (AVBH) were measured by X-ray after the operation. The corrected loss of the above parameters was calculated. RESULTS: There were 5 cases of screw loosening in 84 patients (2 cases in group A and 3 cases in group B, P>0.05). There were significant differences in operation time and intraoperative blood loss between two groups(P<0.01). Clinical effects of two groups were good, postoperative VAS and ODI after operation obviously improved, there was no significant difference between two groups during all follow-up periods (3 days, 1 month after operation and the final follow-up) (P>0.05). Three days after the operation, the image evaluations (Cobb angle, VWA and AVBH) were significantly improved (P<0.05), but significant reduction loss was observed in both groups at 1 month after the operation and at the final follow-up (P<0.05). At the final follow-up, the loss of Cobb angle, VWA and AVBH in group A were (5.26±4.18) °, (4.63±3.80) ° and (9.54±8.71)%, respectively;group B was (6.01±4.34) °, (6.55±6.21) ° and (11.67± 9.95)%, respectively;however, there was no significant difference in reduction loss between the two groups(P>0.05). CONCLUSION: Although the curative effect of the patients is satisfactory, the stability of the patients can not be improved by increasing the middle injured vertebra screw placement, the two groups of percutaneous short segment internal fixation can not resist the reduction loss of Magerl-A3 thoracolumbar fracture with low bone mineral density. Because the injured vertebra screw increases the operation time and intraoperative blood loss, it is not significant to use the intermediate screw for the elderly Magerl A3 thoracolumbar fractures with low bone mineral density.
