Osteoporotic vertebral compression fractures: a visual analysis of current status and emerging trends

Abstract

BACKGROUND: Current literature primarily focuses on comparing the clinical efficacy and surgical safety of various operative approaches for osteoporotic vertebral compression fractures, while there is a notable lack of research addressing the current status, hotspots, and future trends in the treatment and prognosis of osteoporotic vertebral compression fractures. OBJECTIVE: To analyze the current status, hotspots and trends of research on osteoporotic vertebral compression fractures by bibliometric methods. METHODS: English articles related to the treatment and prognosis of osteoporotic vertebral compression fractures published between 1994 and 2023 were retrieved from the Web of Science Core Collection. Bibliometric and visualization analyses were conducted using CiteSpace and VOSviewer to evaluate publication volume, geographic distribution, institutional contributions, journal sources, author contributions, keyword frequency, research hotspots, and the most influential literature. RESULTS AND CONCLUSION: A total of 2,275 articles were included. Global research output on osteoporotic vertebral compression fractures increased annually, with the highest number of publications in 2022 (215 articles). The literature spanned 68 countries/regions, with China leading with 644 articles. Soochow University was the most productive institution (90 articles). European Spine Journal had the highest number of publications (n=146), while Spine had the highest citation count (n=1,923), average citations per article (58.5), and H-index (45), ranking second in publication volume (n=106). Yang, Huilin was the most prolific author (n=65), and French physician Galibert, P had the highest citations (n=300). Early research hotspots focused on 'vertebroplasty', 'balloon kyphoplasty', and 'polymethylmethacrylate', which later shifted to 'surgical management' and 'nonoperative treatment', and more recently expanded to 'safety' and 'risk factors', which are expected to remain future research trends.

1. Introduction

With the global trend of population aging intensifying, vertebral compression fractures caused by osteoporosis have become a major challenge in the field of international public health. Data indicate that approximately 20% of elderly individuals over 70 years old and 16% of postmenopausal women worldwide have experienced osteoporotic vertebral compression fractures [1-3]. Such fractures can lead to persistent pain, spinal deformity, weight loss, and even life-threatening conditions, severely impacting patients' quality of life [4].

Treatment for osteoporotic vertebral compression fractures can be divided into conservative and surgical approaches. Conservative treatment typically includes bed rest, analgesic medication, bracing, and physical therapy [5]. Bed rest generally lasts three to four weeks, while precautions must be taken to prevent complications associated with prolonged immobilization (including deep vein thrombosis, pulmonary infection, pressure ulcers, etc.), and close follow-up is required to prevent progressive vertebral collapse, nonunion, kyphotic deformity, and neurological deficits [6]. Unstable fractures, spinal cord involvement, or failure of conservative treatment necessitate prompt surgical intervention [7]. The goal of surgery is to rapidly relieve pain, restore mechanical stability, and improve early patient mobility. Surgical options for osteoporotic vertebral compression fractures mainly include minimally invasive procedures (such as percutaneous balloon kyphoplasty and percutaneous vertebroplasty) and open surgery (such as pedicle screw fixation). In recent decades, percutaneous vertebroplasty and percutaneous balloon kyphoplasty have been widely used to treat osteoporotic vertebral compression fractures [8], providing rapid pain relief and functional improvement. Percutaneous vertebroplasty was initially...