Predominance of Studies With Poor Level of Evidence Among the Top 100 Most Cited Studies on Idiopathic Scoliosis: A Bibliometric and Content Analysis.

STUDY DESIGN: Bibliometric review of current literature.

OBJECTIVE: To identify and analyze the characteristics of the 100 most cited articles on idiopathic scoliosis focusing on the level of evidence.

SUMMARY OF BACKGROUND DATA: The scientific literature on idiopathic scoliosis has been constantly evolving, but many aspects of its true etiology, natural history, and response to treatment continue to be discussed. To date, no study has used bibliometric analysis to review the most influential articles about idiopathic scoliosis.

METHODS: The Thompson Reuters Web of Science was accessed to find the 100 most cited articles on idiopathic scoliosis. The number and citation density, authorship, institutions, country of origin, year of publication, source journals, type of study, topic, study design, and level of evidence were analyzed.

RESULTS: The 100 most frequently cited articles accumulated 13,749 citations. The number of citations ranged between 616 and 80. The 10 most cited articles represent 24.6% of all citations. The treatment of idiopathic scoliosis is the most commonly studied issue (n = 46), and specifically surgical correction (n = 36). Most studies originated in the United States (n = 62) and were published in Spine (n = 56). Almost half of the papers (n = 49) were published between 2000 and 2008. The majority of studies have a case series design (n = 35). Most of the cited articles have low levels of evidence (Level III = 36; Level IV = 35).

CONCLUSION: This bibliometric analysis includes the 100 most cited articles on idiopathic scoliosis, recognizing its importance as a basic milestone in today's spine knowledge. The results indicate that the evolution of the knowledge on idiopathic scoliosis has been through case reports and case series, which analyzed retrospectively today are considered to have a poor level of evidence. This observation seems to be paradoxical because they are the most influential articles on IS and had been published in the top, leading journals of spine surgery.