Application of Pain Management After Lumbar Spine Surgery: A Bibliometric Analysis of Randomized Controlled Trials.

STUDY

DESIGN

Bibliometric analysis.

OBJECTIVE

To optimize pain management and identify future research trends through bibliometric analysis.

SUMMARY OF BACKGROUND DATA: Postoperative lumbar spine pain is multifactorial and often persists despite successful surgery, reducing patients' quality of life, increasing healthcare use, and increasing the risks of opioid dependence and psychological distress.

METHODS

Data from eligible studies were extracted through a comprehensive search and various analyses, including descriptive bibliometrics, citations, keywords, and thematic analyses. Group comparisons were made between Asian and non-Asian groups to assess differences and trends between the two regions.

RESULTS

Between 1984 and 2025, 197 studies were published, with an average annual increase of 1.70%. At least 10 studies were contributed by the USA, Turkey, Iran, China, and Korea. Studies from the USA had the highest annual citations, whereas those from Spain had the highest citations per article. The focus of most studies (96.45%) was on pharmacological interventions, including anesthetics, opioids, nonsteroidal anti-inflammatory drugs, antipyretic-analgesic drugs, corticosteroids, serotonin-norepinephrine reuptake inhibitors, nonopioid centrally acting analgesics, and nondepolarizing neuromuscular blockers. Among these, intravenous administration was used in 48.22% of the studies, and 58.38% employed a placebo as the control. Additionally, 77.16% of the studies used the Visual Analog Scale to assess pain. Overall, the field has shifted from basic pain management to more personalized and multifaceted perioperative strategies, especially for patients undergoing complex spinal surgeries. Significant differences were observed between the Asian and non-Asian groups regarding publication year and age.

CONCLUSIONS

The number of randomized controlled trials on lumbar postoperative pain has increased, with the USA, Turkey, Iran, and Korea dominating the research. China's lower citation ranking was lower on citation-based indicators; limited international visibility is proposed as a hypothesis for this pattern rather than an established explanation. Driven by the opioid crisis, the field has evolved from opioid-sparing strategies to multimodal, personalized care.