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Spinal Enfeksiyonlarda Küresel Araştırma Eğilimleri: Kapsamlı Bir Bibliyometrik Analiz (1981–2025)

Year 2026, Volume: 17 Issue: 1 , 167 - 182 , 20.04.2026
https://doi.org/10.22312/sdusbed.1899020
https://izlik.org/JA62PZ23XE

Abstract

Amaç: 1981–2025 yılları arasında yayımlanan spinal enfeksiyon literatüründe küresel araştırma eğilimlerini, tematik evrimi, etkili yayınları ve ülke ile kurum düzeyindeki üretkenliği değerlendirmek. Gereç ve Yöntem: Yayınlar Web of Science Core Collection (SCI-E ve ESCI) veritabanında başlık temelli (TI) arama stratejisi kullanılarak belirlendi. Yıllık yayın eğilimleri, ülkelerin ve kurumların katkıları, araştırma alanları ve en çok atıf alan ilk 100 makalenin tematik sınıflandırması analiz edildi. Tanımlayıcı bibliyometrik analizler standart araçlarla görselleştirildi ve alanın entelektüel yapısı ile zamansal evrimini incelemek amacıyla ağ tabanlı haritalama yapıldı. Yüksek etkili çalışmalar içerik ve tematik odak açısından ayrıca değerlendirildi. Bulgular: Toplam 2.174 makale dahil edilme kriterlerini karşıladı. Yayın sayısı 2000 sonrası ve özellikle 2015’ten sonra belirgin artış gösterdi. Amerika Birleşik Devletleri en üretken ülke (596 makale, %27), University of California System ise en üretken kurumdu. Spine (n=156) ve European Spine Journal (n=111) en sık yayın yapılan dergilerdi. Makaleler ağırlıklı olarak ortopedi, beyin cerrahisi/nöroloji ve enfeksiyon hastalıkları alanlarında sınıflandırıldı. İlk 100 analizinde postoperatif enfeksiyonlar, risk faktörleri, spinal epidural apseler ve kılavuz niteliğindeki çalışmalar öne çıktı. Tematik evrim 1980–2000 döneminde patojen odaklı çalışmalardan (tüberküloz, bruselloz), 2000–2010’da postoperatif enfeksiyonlara ve 2010 sonrası minimal invaziv cerrahi, antibiyotik stratejileri ve fonksiyonel sonuçlara doğru bir geçiş göstermiştir. Sonuç: Son 45 yılda literatür küçük olgu serilerinden cerrahi komplikasyonlar, minimal invaziv teknikler ve fonksiyonel sonuçlara odaklanan çalışmalara evrilmiştir. Araştırma üretimi ABD ve Doğu Asya’da yoğunlaşmakla birlikte Türkiye özellikle tüberküloz ve brusellar spondilodiskit alanında önemli katkılar sunmuştur. Gelecekte minimal invaziv cerrahinin uzun dönem sonuçlarına ve antibiyotik ile implant koruyucu stratejilerin optimizasyonuna odaklanılmalıdır.

References

  • 1. Olsen MA, Nepple JJ, Riew KD, Lenke LG, Bridwell KH, Mayfield J, et al. Risk factors for surgical site infection following orthopaedic spinal operations. J Bone Joint Surg Am. 2008 Jan;90(1):62–9.
  • 2. Pull ter Gunne AF, Cohen DB. Incidence, prevalence, and analysis of risk factors for surgical site infection following adult spinal surgery. Spine. 2009 June 1;34(13):1422–8.
  • 3. Pizones J, Moreno-Manzanaro L, Vila-Casademunt A, Fernández-Baíllo N, Sánchez-Márquez J, Talavera G, et al. Adult Congenital Spine Deformity: Clinical Features and Motivations for Surgical Treatment. Int J Spine Surg. 2021 Dec;15(6):1238–45.
  • 4. Häckel S, Phurtag RD, Benneker LM, Liu KB, Albers CE, Hoppe S, et al. Asia Now Surpasses Europe in Spine Research Productivity: An Analysis From 1976–2020. Spine. 2022 June 1;47(11):E477.
  • 5. Zhou JJ, Koltz MT, Agarwal N, Tempel ZJ, Kanter AS, Okonkwo DO, et al. 100 Most Influential Publications in Scoliosis Surgery. Spine. 2017 Mar;42(5):336–44.
  • 6. Donnally CJ, Lugo-Pico JG, Bondar KJ, Chen CJ, McCormick JR, Errico TJ. Characteristics and Trends of the Most Cited Spine Publications. Spine. 2021 June 1;46(11):765–71.
  • 7. Berbari EF, Kanj SS, Kowalski TJ, Darouiche RO, Widmer AF, Schmitt SK, et al. 2015 Infectious Diseases Society of America (IDSA) Clinical Practice Guidelines for the Diagnosis and Treatment of Native Vertebral Osteomyelitis in Adults. Clin Infect Dis Off Publ Infect Dis Soc Am. 2015 Sept 15;61(6):e26-46.
  • 8. Gouliouris T, Aliyu SH, Brown NM. Spondylodiscitis: update on diagnosis and management. J Antimicrob Chemother. 2010 Nov;65 Suppl 3:iii11-24.
  • 9. Hadjipavlou AG, Mader JT, Necessary JT, Muffoletto AJ. Hematogenous pyogenic spinal infections and their surgical management. Spine. 2000 July 1;25(13):1668–79.
  • 10. McHenry MC, Easley KA, Locker GA. Vertebral osteomyelitis: long-term outcome for 253 patients from 7 Cleveland-area hospitals. Clin Infect Dis Off Publ Infect Dis Soc Am. 2002 May 15;34(10):1342–50.
  • 11. Fang A, Hu SS, Endres N, Bradford DS. Risk factors for infection after spinal surgery. Spine. 2005 June 15;30(12):1460–5.
  • 12. Olsen MA, Mayfield J, Lauryssen C, Polish LB, Jones M, Vest J, et al. Risk factors for surgical site infection in spinal surgery. J Neurosurg Spine. 2003 Mar;98(2):149–55.
  • 13. Hlavin ML, Kaminski HJ, Ross JS, Ganz E. Spinal epidural abscess: a ten-year perspective. Neurosurgery. 1990 Aug;27(2):177–84.
  • 14. Carragee EJ. Pyogenic vertebral osteomyelitis. J Bone Joint Surg Am. 1997 June;79(6):874–80.
  • 15. Turunc T, Demiroglu YZ, Uncu H, Colakoglu S, Arslan H. A comparative analysis of tuberculous, brucellar and pyogenic spontaneous spondylodiscitis patients. J Infect. 2007 Aug;55(2):158–63.
  • 16. Akalan N, Ozgen T. Infection as a cause of spinal cord compression: a review of 36 spinal epidural abscess cases. Acta Neurochir (Wien). 2000;142(1):17–23.
  • 17. Ozaksoy D, Yücesoy K, Yücesoy M, Kovanlikaya I, Yüce A, Naderi S. Brucellar spondylitis: MRI findings. Eur Spine J Off Publ Eur Spine Soc Eur Spinal Deform Soc Eur Sect Cerv Spine Res Soc. 2001 Dec;10(6):529–33.
  • 18. Benli IT, Kaya A, Acaroğlu E. Anterior instrumentation in tuberculous spondylitis: is it effective and safe? Clin Orthop. 2007 July;460:108–16.
  • 19. Güzey FK, Emel E, Bas NS, Hacisalihoglu S, Seyithanoglu MH, Karacor SE, et al. Thoracic and lumbar tuberculous spondylitis treated by posterior debridement, graft placement, and instrumentation: a retrospective analysis in 19 cases. J Neurosurg Spine. 2005 Dec;3(6):450–8.
  • 20. Togan T, Azap OK, Durukan E, Arslan H. The prevalence, etiologic agents and risk factors for urinary tract infection among spinal cord injury patients. Jundishapur J Microbiol. 2014 Jan;7(1):e8905.
  • 21. Bayindir Y, Sonmez E, Aladag A, Buyukberber N. Comparison of five antimicrobial regimens for the treatment of brucellar spondylitis: a prospective, randomized study. J Chemother. 2003 Oct;15(5):466–71.
  • 22. Eren Gök S, Kaptanoğlu E, Celikbaş A, Ergönül O, Baykam N, Eroğlu M, et al. Vertebral osteomyelitis: clinical features and diagnosis. Clin Microbiol Infect Off Publ Eur Soc Clin Microbiol Infect Dis. 2014 Oct;20(10):1055–60.
  • 23. Bezer M, Kucukdurmaz F, Aydin N, Kocaoglu B, Guven O. Tuberculous spondylitis of the lumbosacral region: long-term follow-up of patients treated by chemotherapy, transpedicular drainage, posterior instrumentation, and fusion. J Spinal Disord Tech. 2005 Oct;18(5):425–9.
  • 24. Erdem H, Elaldi N, Batirel A, Aliyu S, Sengoz G, Pehlivanoglu F, et al. Comparison of brucellar and tuberculous spondylodiscitis patients: results of the multicenter “Backbone-1 Study.” Spine J Off J North Am Spine Soc. 2015 Dec 1;15(12):2509–17.
  • 25. Akiyama T, Chikuda H, Yasunaga H, Horiguchi H, Fushimi K, Saita K. Incidence and risk factors for mortality of vertebral osteomyelitis: a retrospective analysis using the Japanese diagnosis procedure combination database. BMJ Open. 2013 Mar 25;3(3):e002412.

Global Research Trends in Spinal Infections: A Comprehensive Bibliometric Analysis (1981–2025)

Year 2026, Volume: 17 Issue: 1 , 167 - 182 , 20.04.2026
https://doi.org/10.22312/sdusbed.1899020
https://izlik.org/JA62PZ23XE

Abstract

Objective: To evaluate global research trends, thematic evolution, influential publications, and country- and institution-level productivity in spinal infection literature published between 1981 and 2025. Materials and Methods: Publications were identified using a title-based (TI) search in the Web of Science Core Collection (SCI-E and ESCI). Annual publication trends, contributions of countries and institutions, research areas, and thematic classification of the top 100 most cited articles were analyzed. Descriptive bibliometric analyses were visualized using standard tools, and network-based mapping was performed to explore the intellectual structure and temporal evolution of the field. High-impact studies were further assessed for content and thematic focus. Results: A total of 2,174 articles met the inclusion criteria. Publication output increased markedly after 2000 and again after 2015. The United States was the most productive country (596 articles, 27%), and the University of California System was the leading institution. Spine (n=156) and European Spine Journal (n=111) were the most frequent publishing journals. Articles were primarily classified under orthopedics, neurosurgery/neurology, and infectious diseases. In the Top-100 analysis, postoperative infections, risk factors, spinal epidural abscesses, and guideline papers predominated. Thematic evolution demonstrated a transition from pathogen-focused studies (tuberculosis, brucellosis) between 1980 and 2000 to postoperative infections between 2000 and 2010 and, after 2010, to minimally invasive surgery, antibiotic strategies, and functional outcomes. Conclusion: Over 45 years, the literature evolved from small case series to studies emphasizing surgical complications, minimally invasive techniques, and functional outcomes. Although research output is concentrated in the United States and East Asia, Türkiye has contributed notably, particularly in tuberculous and brucellar spondylodiscitis. Future research should prioritize long-term outcomes of minimally invasive surgery and optimization of antibiotic and implant-preserving strategies.

References

  • 1. Olsen MA, Nepple JJ, Riew KD, Lenke LG, Bridwell KH, Mayfield J, et al. Risk factors for surgical site infection following orthopaedic spinal operations. J Bone Joint Surg Am. 2008 Jan;90(1):62–9.
  • 2. Pull ter Gunne AF, Cohen DB. Incidence, prevalence, and analysis of risk factors for surgical site infection following adult spinal surgery. Spine. 2009 June 1;34(13):1422–8.
  • 3. Pizones J, Moreno-Manzanaro L, Vila-Casademunt A, Fernández-Baíllo N, Sánchez-Márquez J, Talavera G, et al. Adult Congenital Spine Deformity: Clinical Features and Motivations for Surgical Treatment. Int J Spine Surg. 2021 Dec;15(6):1238–45.
  • 4. Häckel S, Phurtag RD, Benneker LM, Liu KB, Albers CE, Hoppe S, et al. Asia Now Surpasses Europe in Spine Research Productivity: An Analysis From 1976–2020. Spine. 2022 June 1;47(11):E477.
  • 5. Zhou JJ, Koltz MT, Agarwal N, Tempel ZJ, Kanter AS, Okonkwo DO, et al. 100 Most Influential Publications in Scoliosis Surgery. Spine. 2017 Mar;42(5):336–44.
  • 6. Donnally CJ, Lugo-Pico JG, Bondar KJ, Chen CJ, McCormick JR, Errico TJ. Characteristics and Trends of the Most Cited Spine Publications. Spine. 2021 June 1;46(11):765–71.
  • 7. Berbari EF, Kanj SS, Kowalski TJ, Darouiche RO, Widmer AF, Schmitt SK, et al. 2015 Infectious Diseases Society of America (IDSA) Clinical Practice Guidelines for the Diagnosis and Treatment of Native Vertebral Osteomyelitis in Adults. Clin Infect Dis Off Publ Infect Dis Soc Am. 2015 Sept 15;61(6):e26-46.
  • 8. Gouliouris T, Aliyu SH, Brown NM. Spondylodiscitis: update on diagnosis and management. J Antimicrob Chemother. 2010 Nov;65 Suppl 3:iii11-24.
  • 9. Hadjipavlou AG, Mader JT, Necessary JT, Muffoletto AJ. Hematogenous pyogenic spinal infections and their surgical management. Spine. 2000 July 1;25(13):1668–79.
  • 10. McHenry MC, Easley KA, Locker GA. Vertebral osteomyelitis: long-term outcome for 253 patients from 7 Cleveland-area hospitals. Clin Infect Dis Off Publ Infect Dis Soc Am. 2002 May 15;34(10):1342–50.
  • 11. Fang A, Hu SS, Endres N, Bradford DS. Risk factors for infection after spinal surgery. Spine. 2005 June 15;30(12):1460–5.
  • 12. Olsen MA, Mayfield J, Lauryssen C, Polish LB, Jones M, Vest J, et al. Risk factors for surgical site infection in spinal surgery. J Neurosurg Spine. 2003 Mar;98(2):149–55.
  • 13. Hlavin ML, Kaminski HJ, Ross JS, Ganz E. Spinal epidural abscess: a ten-year perspective. Neurosurgery. 1990 Aug;27(2):177–84.
  • 14. Carragee EJ. Pyogenic vertebral osteomyelitis. J Bone Joint Surg Am. 1997 June;79(6):874–80.
  • 15. Turunc T, Demiroglu YZ, Uncu H, Colakoglu S, Arslan H. A comparative analysis of tuberculous, brucellar and pyogenic spontaneous spondylodiscitis patients. J Infect. 2007 Aug;55(2):158–63.
  • 16. Akalan N, Ozgen T. Infection as a cause of spinal cord compression: a review of 36 spinal epidural abscess cases. Acta Neurochir (Wien). 2000;142(1):17–23.
  • 17. Ozaksoy D, Yücesoy K, Yücesoy M, Kovanlikaya I, Yüce A, Naderi S. Brucellar spondylitis: MRI findings. Eur Spine J Off Publ Eur Spine Soc Eur Spinal Deform Soc Eur Sect Cerv Spine Res Soc. 2001 Dec;10(6):529–33.
  • 18. Benli IT, Kaya A, Acaroğlu E. Anterior instrumentation in tuberculous spondylitis: is it effective and safe? Clin Orthop. 2007 July;460:108–16.
  • 19. Güzey FK, Emel E, Bas NS, Hacisalihoglu S, Seyithanoglu MH, Karacor SE, et al. Thoracic and lumbar tuberculous spondylitis treated by posterior debridement, graft placement, and instrumentation: a retrospective analysis in 19 cases. J Neurosurg Spine. 2005 Dec;3(6):450–8.
  • 20. Togan T, Azap OK, Durukan E, Arslan H. The prevalence, etiologic agents and risk factors for urinary tract infection among spinal cord injury patients. Jundishapur J Microbiol. 2014 Jan;7(1):e8905.
  • 21. Bayindir Y, Sonmez E, Aladag A, Buyukberber N. Comparison of five antimicrobial regimens for the treatment of brucellar spondylitis: a prospective, randomized study. J Chemother. 2003 Oct;15(5):466–71.
  • 22. Eren Gök S, Kaptanoğlu E, Celikbaş A, Ergönül O, Baykam N, Eroğlu M, et al. Vertebral osteomyelitis: clinical features and diagnosis. Clin Microbiol Infect Off Publ Eur Soc Clin Microbiol Infect Dis. 2014 Oct;20(10):1055–60.
  • 23. Bezer M, Kucukdurmaz F, Aydin N, Kocaoglu B, Guven O. Tuberculous spondylitis of the lumbosacral region: long-term follow-up of patients treated by chemotherapy, transpedicular drainage, posterior instrumentation, and fusion. J Spinal Disord Tech. 2005 Oct;18(5):425–9.
  • 24. Erdem H, Elaldi N, Batirel A, Aliyu S, Sengoz G, Pehlivanoglu F, et al. Comparison of brucellar and tuberculous spondylodiscitis patients: results of the multicenter “Backbone-1 Study.” Spine J Off J North Am Spine Soc. 2015 Dec 1;15(12):2509–17.
  • 25. Akiyama T, Chikuda H, Yasunaga H, Horiguchi H, Fushimi K, Saita K. Incidence and risk factors for mortality of vertebral osteomyelitis: a retrospective analysis using the Japanese diagnosis procedure combination database. BMJ Open. 2013 Mar 25;3(3):e002412.
There are 25 citations in total.

Details

Primary Language English
Subjects Orthopaedics
Journal Section Research Article
Authors

Mustafa Toker 0000-0002-0697-9497

Nurdan Pür 0000-0001-6701-7788

Submission Date February 27, 2026
Acceptance Date March 14, 2026
Publication Date April 20, 2026
DOI https://doi.org/10.22312/sdusbed.1899020
IZ https://izlik.org/JA62PZ23XE
Published in Issue Year 2026 Volume: 17 Issue: 1

Cite

Vancouver 1.Mustafa Toker, Nurdan Pür. Global Research Trends in Spinal Infections: A Comprehensive Bibliometric Analysis (1981–2025). Süleyman Demirel Üniversitesi Sağlık Bilimleri Dergisi. 2026 Apr. 1;17(1):167-82. doi:10.22312/sdusbed.1899020