Global trends and hotspots of macrophage-related research in intervertebral disc degeneration from 2005 to 2025: a bibliometric and visualized analysis.

BACKGROUND: Macrophage-mediated imbalances in the immune microenvironment are critical to the pathogenesis of intervertebral disc degeneration (IVDD). Consequently, targeting macrophage polarization to remodel the degenerative microenvironment and promote tissue repair has emerged as a major research hotspot. However, systematic bibliometric analyses of this interdisciplinary field remain scarce. This study utilizes bibliometric methods to elucidate the current landscape, intellectual base, and research frontiers of macrophage involvement in IVDD, providing quantitative data to support the development of novel immunotherapies. METHODS: We retrieved literature investigating the role of macrophages in IVDD, published between 2005 and 2025, from the WoSCC and Scopus databases. Following deduplication and data standardization, 550 publications were included. We employed CiteSpace, VOSviewer, and the R package "bibliometrix" to conduct visual analyses of contributing countries, institutions, journals, and authors. Additionally, we mapped keyword co-occurrence and citation burst networks to quantitatively evaluate evolutionary trends and research hotspots. RESULTS: Publications in this field have surged significantly since 2021. China and USA are the primary contributors, although multinational collaborative networks remain limited. Frontiers in Immunology and Spine represent the core journals driving this discipline. Keyword clustering reveals five primary research domains: pathological mechanisms, ECM regulation, tissue regeneration, multi-omics, and clinical diagnostics. Furthermore, citation burst analyses identify "single-cell sequencing," "oxidative stress," "injectable hydrogels," and "tissue regeneration" as current research epicenters. CONCLUSION: IVDD research has undergone a critical paradigm shift, transitioning from traditional morphological observation to precision immunometabolic intervention. Currently, the research frontier focuses on integrating high resolution single cell transcriptomics with advanced nanoscale delivery systems, such as lipid nanoparticles and functionalized hydrogels, to proactively reprogram macrophage phenotypes. Ultimately, this study provides a robust quantitative framework to guide the clinical development of targeted nonsurgical immunotherapies and regenerative strategies for discogenic pain.