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. 2025 Nov;17(11):3185-3200.
doi: 10.1111/os.70162. Epub 2025 Sep 20.

Bibliometric and Visualized Analysis of Research Relating to Spinal Modic Changes Reported Over the Period 2004-2024

Haixin Wei  1 , Hui Lu  1 , Lei Li  1 , Changpeng Qu  1 , Hao Zhang  1 , Xuexiao Ma  1
Affiliations

Bibliometric and Visualized Analysis of Research Relating to Spinal Modic Changes Reported Over the Period 2004-2024

Haixin Wei et al. Orthop Surg. 2025 Nov.

Abstract

Objective: Modic changes (MC) are pathological signal alterations occurring in the vertebral endplates and adjacent bone marrow. These changes are frequently linked to degenerative disc diseases and are associated with low back pain symptoms. However, despite increasing research interest, existing studies are fragmented, mostly descriptive, and lack a comprehensive, quantitative assessment of research patterns, hotspots, and collaboration networks in this field. This study aims to evaluate the current research landscape and global trends regarding spinal MC using bibliometric analysis.

Methods: We retrieved relevant publications on spinal MC from the Web of Science Core Collection database, spanning January 2004 to August 2024. Using CiteSpace, we conducted a comprehensive analysis of keywords, co-authors, institutions, countries, research domains, cited literature, cited authors, and cited journals.

Results: This study analyzed 603 articles published in 168 journals from 193 countries. China emerged as the leading contributor in terms of publication volume, while the University of Oulu in Finland demonstrated the most significant institutional impact. J. Karppinen was identified as the most prolific author, whereas M. Modic was the most frequently cited. Among journals, Spine accounted for the highest number of publications and citations. Key research hotspots identified through keyword analysis include "degenerative disease," "bone marrow changes," "abnormalities," "type II changes," "lower back," "protrusion," "discectomy," "paraspinal muscles," "obesity," and "overweight".

Conclusion: This study represents the first known bibliometric analysis and visualization of MC, offering clinicians valuable insights into research priorities and directions. Future investigations should prioritize the classification, pathophysiological mechanisms, and clinical significance of different types of MC, especially their roles in pain and functional impairment. Research should also explore the impact of obesity and paraspinal muscles on the progression of MC. Moreover, studies should examine the potential benefits of weight loss and muscle strengthening in alleviating symptoms. Finally, researchers should focus on leveraging artificial intelligence to improve the identification and understanding of MC.

Keywords: CiteSpace; Modic changes; bibliometrics; clinical relevance; visual analysis.

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Conflict of interest statement

All authors listed in this manuscript meet the authorship criteria outlined by the latest guidelines of the International Committee of Medical Journal Editors (ICMJE).

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Flow chart of literature retrieval in research.
FIGURE 2
FIGURE 2
The annual publications of MC articles from 2004 to 2024.
FIGURE 3
FIGURE 3
National/regional cooperation network of publications on Modic changes. Node size represents the number of publications from each country/region. Node color corresponds to the average year of publication (lighter colors indicate more recent publications). Edges represent collaborative relationships, and thicker lines indicate stronger co‐authorship intensity.
FIGURE 4
FIGURE 4
The institute co‐authorship network of publications.
FIGURE 5
FIGURE 5
The author co‐authorship network of publications. Node size indicates the number of publications by each author. Node color reflects the average publication year. Links represent co‐authorship strength; denser connections imply frequent collaboration.
FIGURE 6
FIGURE 6
The cited author network of publications.
FIGURE 7
FIGURE 7
The cited literature network of publications.
FIGURE 8
FIGURE 8
The cited journal network of publications.
FIGURE 9
FIGURE 9
The subject network of publications.
FIGURE 10
FIGURE 10
Keywords co‐occurrence network of publications.
FIGURE 11
FIGURE 11
The cluster view map. The map is divided into several small grids, and the locations in each grid are grouped into a cluster. The smaller the number, the more keywords are included in the clusters.
FIGURE 12
FIGURE 12
The keyword clustering timeline of publications, the node size represents the weight of keywords, and different lines represent different clusters.
FIGURE 13
FIGURE 13
Top 13 keywords with the strongest citation burst values.
FIGURE 14
FIGURE 14
Time zone view and association of keywords for publications on MC.
See this image and copyright information in PMC

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