Swespine in the literature: a bibliometric analysis of trends and characteristics of publications.

BACKGROUND: The Swedish Spine Register (Swespine) is a nationwide quality registry that prospectively collects detailed clinical and patient-reported data on spine surgery. While it has generated a substantial body of scientific literature, a systematic overview of publication trends, study characteristics, and research focus areas is lacking. This study aimed to bibliometrically characterize publication output, research trends, study designs, citation patterns, and clinical focus areas among publications using Swespine data. METHODS: A bibliometric analysis was conducted. PubMed MEDLINE and EMBASE were searched from inception to March 8, 2026. Original studies utilizing Swespine data were included following independent screening by two reviewers. Descriptive statistics, trend analyses, and correlation analyses were performed. RESULTS: A total of 157 studies were included. Most studies were retrospective (n = 134), with fewer prospective randomized (n = 12) and prospective non-randomized studies (n = 5). Publication output increased over time, peaking in 2022 and 2025. The median of total citations per article was 12 (IQR 4-39). Publications were most commonly found in spine-focused journals. Citation counts were positively correlated with journal impact factor (r = 0.85-0.91, p < 0.001). Research predominantly focused on degenerative lumbar spine pathology (n = 74), particularly lumbar disc herniation and spinal stenosis, although a significant increase in cervical spine research was observed over time (p < 0.001). A limited number of authors contributed a disproportionate share of publications. Less common topics included deformity, trauma, and metastatic disease. CONCLUSION: The Swespine registry has generated a substantial and growing body of scientific literature. Its longitudinal design, patient-reported outcomes, and national coverage make it a usefiul resource for studying spine surgery in Sweden. However, its single-country setting, incomplete coverage and population-specific characteristics limit generalizability to global populations. Future research should emphasize international comparisons, and better inclusion of underrepresented groups and conditions.