Study Design. Bibliometric literature review.Objective. The aim of this study was to recognize and analyze the most frequently cited manuscripts published in the journal Spine. Summary of Background Data. Although the journal Spine is considered a premiere location for distributing influential spine research, no previous study has evaluated which of their publications have had the most impact. Knowledge and appreciation of the most influential Spine publications can guide and inspire future research endeavors. Methods. Using the Scopus database, the 100 most cited articles published in Spine were accessed. The frequency of citations, year of publication, country of origin, level-of-evidence (LOE), article type, and contributing authors/institutions were recorded. The 10 most cited articles (per year) from the past decade were also determined. Results. ''Guidelines For The Process Of Cross-Cultural Adaptation Of Self-Report Measures'' by Beaton DE was the most cited article with 2960 citations. 2000 to 2009 (n ¼ 46) was the most productive period. A LOE of III (n ¼ 35) followed by II (n ¼ 34) were the most common. Deyo RA (n ¼ 8), Bombardier C (n ¼ 6), and Waddell G (n ¼ 6) produced the most articles. University of Washington (n ¼ 8) and University of Toronto (n ¼ 8) ranked first for institutional output. Clinical Outcome (n ¼ 28) was the most recurring article topic. The United States (n ¼ 51) ranked first for country of origin.
Conclusion.Using citation analysis as an objective proxy for influence, certain publications can be distinguished from others due to their lasting impact and recognition from peers. Of the top cited Spine publications, many pertained to clinical outcomes (28%) and had a LOE of I, II, or III (60%). Although older publications have had longer time to accrue citations, those in the most recent decade comprise this list almost 2:1. Knowledge of these ''classic'' publications allows for a better overall understanding of the diagnosis, management, and future direction of spine health care.