Characteristics of the top 100 most cited prepsoas (anterior to psoas/oblique lumbar interbody fusion) lumbar interbody fusion articles: A bibliometric study of the literature

ABSTRACT Purpose: This study sought to characterize the most influential literature on prepsoas approaches to fusions, anterior to psoas (ATP) and oblique lumbar interbody fusion (OLIF), and identify the global research trends, citation patterns, and article levels of evidence for these two popular minimally invasive approaches. Methods: The Clarivate Web of Science databases were searched for phrasings for ATP and OLIF fusions. The 100 most-cited articles were screened for inclusion, and study characteristics were extracted, including citation count, country of origin, journal, year of publication, and level of evidence (LOE). Citation density and citations per year (CPY) were calculated. Network analyses were conducted on author keywords. Correlation of LOE and citation metrics was assessed with Spearman analysis, and multivariable regression was performed to identify predictors of citation impact. Results: The top 100 prepsoas articles had 6323 citations (mean 63.0 ± 73.0, range 18–494) with a mean CPY of 10.2 ± 7.5. Most were retrospective cohorts ( n = 35). Their classification was level III ( n = 42), level IV (n = 26), or level V ( n = 16), with only a single randomized controlled trial. There was no significant relationship between LOE and the number of citations (ρ =0.024, P = 0.823). China ( n = 45) was the most commonly represented country, followed by the United States ( n = 17) and South Korea ( n = 13). Conclusion: Despite their rapid global adoption, higher-level evidence prepsoas literature remains very limited, showing the need for prospective trials and systematic reviews to further validate their safety and efficacy.