近二十年全球脊柱外科医师培训研究的文献计量学分析

Bibliometric Analysis of Global Spine Surgery Training Research over the Past Two Decades

摘要: 目的：脊柱外科教育因传统师徒模式与复杂手术需求的结构性错配面临范式重构，3D打印技术和混合现实技术通过提升螺钉置入精准度至94.2%及缩短手术规划时间42%推动教育转型，但技术鸿沟导致发展中国家设备可及率仅23%；方法：本研究采用文献计量学方法分析Web of Science数据库2004~2025年498篇文献，结合VOSviewer/CiteSpace工具量化期刊影响力、国家贡献及主题演进，并通过关键词共现聚类(阈值 ≥ 20次)和突现检测验证；结果：美国以286篇文献主导学术生态，但其发文比例呈现逐年减少趋势。研究主题从椎弓根螺钉置入(爆发强度5.24)转向人工智能(强度3.63)与能力评估，《World Neurosurgery》以41篇载文量确立旗舰地位，哈佛大学与梅奥诊所构成全球协作枢纽。结论：技术驱动、全球重构与评估革新如NASA-TLX量表和AI工具正重塑教育体系，需通过包容性生态如三方投资模式防范技能弱化风险，实现“精准培训–标准评估–普惠接入”新范式。

Abstract: Objective: Spine surgery education is undergoing a paradigm shift due to the structural mismatch between traditional apprenticeship models and the complexities of modern surgical demands. Technologies such as 3D printing and mixed reality have facilitated this transformation by improving screw placement accuracy to 94.2% and reducing surgical planning time by 42%. However, a technological divide persists, with device accessibility in developing countries as low as 23%. Methods: This study employed bibliometric methods to analyze 498 publications from the Web of Science database between 2004 and 2025. Using VOSviewer and CiteSpace, we quantified journal influence, national contributions, and thematic evolution. Keyword co-occurrence clustering (threshold ≥ 20) and burst detection were applied for validation. Results: The United States dominated the academic landscape with 286 publications, though its proportion of output showed a declining trend over time. Research themes shifted from pedicle screw placement (burst strength 5.24) to artificial intelligence (strength 3.63) and competency-based assessment. World Neurosurgery emerged as the leading journal with 41 publications, while Harvard University and the Mayo Clinic served as global collaboration hubs. Conclusion: Technology-driven advancements, global restructuring, and evaluation innovations—such as the NASA-TLX scale and AI tools—are reshaping training systems. An inclusive ecosystem, exemplified by tripartite investment models, is essential to mitigate skill attenuation risks and achieve a new paradigm of “precision training-standardized assessment-inclusive access.”.