Age-related spinal degenerative diseases: a quantitative analysis of the dynamic evolution, knowledge structure, and research frontiers in neurological damage

Background and purpose Aging is the primary risk factor for the four major spinal degenerative diseases of lumbar disc herniation (LDH), cervical spondylosis (CS), lumbar spinal stenosis (LSS) and thoracic disc herniation (TDH). These diseases can lead to severe neurological dysfunction, chronic neuropathic pain and a decline in the quality of life in elderly patients. This article conducts the first simultaneous, comparative bibliometric analysis of these broader age-related spinal degenerative diseases within a unified framework, identifying the mitigation of neurological damage and neuropathic pain as the key thematic findings that currently drive the field. Methods This study conducts a quantitative analysis of the scientific literature of LDH, CS, LSS and TDH. Our system retrieved the articles and reviews published in Web of Science, Scopus and PubMed from January 1, 2015 to April 4, 2025. We used VOSviewer and CiteSpace to draw bibliometric maps to clarify publication trends, cooperation networks and research frontiers. Results The analysis of 15,788 documents shows that the global volume of articles is on a continuous growth trend, mainly dominated by China and the United States. Keyword co-occurrence analysis shows that “magnetic resonance imaging (MRI)” is the most core topic. The analysis of keyword burst and co-citation reveals a major paradigm shift: this field is gradually moving away from open surgery (such as laminoplasty) and traditional measurement, turning to minimally invasive neurodecompression and artificial intelligence, and paying more attention to specific pathologies such as patient-reported outcomes (PROs) and degenerative cervical myelopathy (DCM). Conclusion This bibliometric study reveals that minimally invasive neural decompression, intelligence and precision methods are the primary research hotspots of recent progress. This field is changing from traditional surgery to a new paradigm combining endoscopic surgery, artificial intelligence decision-making and personalized elderly neuroprotection. However, readers must differentiate that these represent current academic research hotspots rather than definitively proven clinical evidence. Future research should integrate artificial intelligence, new robots, endoscopic technology and translation.