A special review in the May 2015 issue of Spine counts down the top 100 research papers on lumbar spine surgery and finds that, according to a news release from Wolters Kluwer Health: Linppincott Williams and Wilkins, the two most-cited studies focus on situations in which spinal surgery should not be performed.

Samuel K. Cho, MD, and colleagues from the Icahn School of Medicine at Mount Sinai, New York, performed the literature review in order to identify the 100 most frequently cited research papers relevant to lumbar spine surgery and published in spine-related journals, as citation is a key measure of the relevance and importance of the medical studies the release explains.

After reviewing more than 16,500 papers that matched the search criteria, the research team found 322 that were cited at least 100 times, according to the release. The top-ranked paper—cited more than 1,000 times—was a 1990 study that showed that many people have common spinal abnormalities on magnetic resonance imaging scans, despite experiencing no back pain or other symptoms.

The paper in second place and published in 1994 focused on a similar topic as the top-ranked study, and highlighted the need for a “clear correlation” of patients’ symptoms and image findings, the release says. A review of a survey tool (the Oswestry Disability Index) assessing the impact of low back pain on patients’ lives and published in 2000 was the third most-cited paper, according to the news release.

The papers’ most common topic was low back pain, addressed by 23 out of the top 100 studies. Other frequent topics included spinal biomechanics and degenerative disc disease. About half were published during the 1990s, and most originated in the United States. Overall, 63 out of the top 100 papers were published in Spine, the release notes.

Richard A. Deyo, MD, MPH, a researcher at Oregon Health and Science University and a leading authority on patient outcomes research, was the most frequently cited author, the news release continues.

The other two most frequently cited authors, per the release, were Scott D. Boden, MD, of Emory University, Atlanta, and James Weinstein, DO, MS, of the Dartmouth Institute, Lebanon, NH. All three authors, the release explains, contributed to the SPORT study that compared the benefits of surgical versus nonsurgical treatment for sciatica from herniated lumbar discs. Weinstein is editor-in-chief of Spine, and Boden and Deyo are deputy editors.

Cho and his colleagues believe that their study provides insights into the development and trends of lumbar spine surgery, per the release. “This paper identifies those individuals whose contributions to the ever-growing body of knowledge have provided guidance and suggestions for further investigation,” they add.

[Sources: Wolters Kluwer Health: Lippincott Williams and Wilkins, Newswise]