Artificial Intelligence in Spine Surgery: A Bibliometric and Visualization Analysis of Research Hotspots and Trends

Annual publication output showed a sustained upward trajectory, with a marked acceleration after 2020 and peaking in 2025. The United States ranked first in publication volume and citation impact, followed by China as the second-largest contributor, with Germany, Switzerland, and the United Kingdom also playing significant roles. Spine and The Spine Journal were the most productive and most cited journals, while open-access multidisciplinary journals provided strong evidence of the field's interdisciplinary nature.

International collaboration was strongest among the United States, Canada, China, and European nations. Research hotspots evolved from early machine learning algorithm validation and image segmentation techniques, through augmented reality-guided navigation and predictive modeling, to the current frontiers of large language model-assisted decision support, multi-centre external validation, and long-term prognostic assessment.

Emerging topics include multimodal data fusion, personalised surgical planning, and clinical translation of AI models. This evolution indicates that spinal surgery and artificial intelligence research has been moving steadily toward clinically oriented outcome prediction, integrated decision support, and data-driven precision spinal care.