Most Cited Publications in Cervical Spine Surgery ================================================= * Yu Chao Lee * Francis Brooks * Simon Sandler * Yun-Hom Yau * Michael Selby * Brian Freeman ## Abstract **Purpose** The purpose of this study is to perform a citation analysis on the most frequently cited articles in the topic of cervical spine surgery and report on the top 100 most cited publication in this topic. **Methods** We used the Thomson Reuters Web of Science to search citations of all articles from 1945 to 2015 relevant to cervical spine surgery and ranked them according to the number of citations. The 100 most cited articles that matched the search criteria were further analyzed by number of citations, first author, journal, year of publication, country and institution of origin. **Results** The top 100 cited articles in the topic of cervical spine surgery were published from 1952-2011. The number of citations ranged from 106 times for the 100th paper to 1206 times for the top paper. The decade of 1990-1999 saw the most publications. The Journal of Spine published the most articles, followed by Journal of Bone and Joint Surgery America. Investigators from America authored the most papers and The University of California contributed the most publications. Cervical spine fusion was the most common topic published with 36 papers, followed by surgical technique and trauma. **Conclusion** This article identifies the 100 most cited articles in cervical spine surgery. It has provided insight to the history and development in cervical spine surgery and many of which have shaped the way we practice today. * cervical spine * surgery * citation ## Introduction Cervical spine surgery owes its advancement to key research which has shaped modern practice. Many papers are published in this area but only a few make a lasting impact to the scientific community. A citation is recognition of an author’s work by their peers and may acknowledge the impact that their work has. Bibliometric analysis has become a popular way of providing an insight into advancements and highlighting key articles in a certain field. Several studies have evaluated the impact that articles have made in their respective field.1-4 Citation analysis involves evaluating an article based on the number of citations it receives. The list it generates may identify individuals who have contributed greatly to the scientific community. The purpose of this study is to identify trends and characteristics which make an article highly cited in the field of cervical spine surgery. We performed a citation analysis on the most frequently cited articles in cervical spine surgery using methods validated in other similar published studies.1-4 ## Methods The Institute for Scientific information has collected information on journal citations since 1945. Their current system is known as “Science Citation index” and this database was searched using the Thomson Reuters Web of Science for all articles from 1945 to 2015. The search term was “Cervical Spine” and it was limited to the English language. This search was performed in November 2015. The results were then carefully reviewed by two authors (YL and FB) and only those relevant to the cervical spine were selected. The 100 most cited articles that matched the search criteria were further analyzed by number of citations, first author, journal, year of publication, country and institution of origin and level of evidence. The total numbers of citations were compared to the average yearly citation for each article. ## Results The 100 most cited articles in the topic of cervical spine surgery were published from 1952-2011. These papers, their corresponding authors, and number of citations are shown in Table 1. The number of citations ranged from 106 times for the 100th paper to 1206 times for the top paper in a total of 15 journals. The decade of 1990-1999 saw the most publications with 36 articles, followed by 2000-2009 with 33 articles (Table 2). The oldest article was by Bailey5 published in 1952; and Carragee et al.6 published the most recent article in 2011. View this table: [Table 1](http://ijssurgery.com//content/11/3/19/T1) Table 1 Top 100 cited papers in Cervical Spine Surgery. View this table: [Table 2](http://ijssurgery.com//content/11/3/19/T2) Table 2 Publication dates. The Spine Journal published the most articles (48 articles), followed by the Journal of Bone and Joint Surgery, America. The top two journals published 57% of all articles (Table 3). Investigators from America authored 52 of the 100 articles, followed by authors from Japan with 13 articles and Germany with 7 articles (Table 4). The institution that contributed the most was the University of California with 9 publications in the top 100 (Table 5). A total of 9 authors contributed ≥ 3 publications with Abumi, K and Bohlmann H, having 5 publications in the top 100 (Table 6). View this table: [Table 3](http://ijssurgery.com//content/11/3/19/T3) Table 3 Top Journals of Publication. View this table: [Table 4](http://ijssurgery.com//content/11/3/19/T4) Table 4 Country of Origin for Top articles. View this table: [Table 5](http://ijssurgery.com//content/11/3/19/T5) Table 5 Top institutions of origin of articles. View this table: [Table 6](http://ijssurgery.com//content/11/3/19/T6) Table 6 Top authors. Cervical spine fusion was the most common topic published with 36 articles, followed by articles on surgical technique and trauma (Table 7). When the level of evidence is reviewed, we found that the most common level of evidence was 3 with only two articles being level 1 (Figure 1). We found that only 24 articles were rated as level 1 or 2 with the remainder being rated as 3 and 4 (Table 1). View this table: [Table 7](http://ijssurgery.com//content/11/3/19/T7) Table 7 Most popular topic ranked by number of papers. ![Fig. 1](http://ijssurgery.com//https://www.ijssurgery.com/content/ijss/11/3/19/F1.medium.gif) [Fig. 1](http://ijssurgery.com//content/11/3/19/F1) Fig. 1 Level of Evidence. Comparison was made between the total number of citations with the average number of citations per year. There was a variation in the ranking with 7 articles ranked in the top 10 by total number of citations and also ranked in the top 10 when ranked by average (Table 8). View this table: [Table 8](http://ijssurgery.com//content/11/3/19/T8) Table 8 Comparison of rank by number of citations per year and total citations. ## Discussion This study identifies the most cited papers on the cervical spine. It provides the features which make an article likely to be highly cited and highlights the journals which may allow work to be cited. The top most cited paper with 1206 citations is the work by Frankel et al.7 on postural reduction in the management of closed injuries of the spine with paraplegia or tetraplegia. While such treatment method is less common, their work on classifying neurological impairment became the basis of the spinal assessment in spinal cord injury patients as part of the American Spinal Injury Association (ASIA) neurological impairment scale.8 In their initial description, complete and incomplete spinal cord injuries were subdivided into five categories, without detailing assessment of motor or sensory function.7 This was subsequently modified by the ASIA with the addition of key muscle function, key sensory points and presence of sacral sparing added as part of assessment to clarify zones of partial preservation.8 This allows greater precision and consistency in defining the extent of spinal cord injury amongst clinicians and researchers. The second most cited paper is the work by Vernon and Moir,9 describing the neck disability index (NDI), which became the first instrument designed to assess self-rated disability in patients with neck pain. Vernon modelled the NDI on the Oswestry Low Back Pain Disability Questionnaire with the permission of the authors.10 Since 1991, the NDI has become the most widely used questionnaire for neck pain, with 959 citations, translation into over 20 languages, and a widely used outcome measure in clinical studies.11 The NDI has been useful for prognostication of outcome following whiplash injury, with several studies reporting a low initial NDI predicting recovery and a high score predicting chronicity.11 In addition, high NDI score (>15/50) at 3-36 months following injury strongly correlates with physiological dysfunction such as muscular dysfunction and central sensitization.11 The third most cited paper is by Smith and Robinson,12 who first describe the anterior approach to the cervical spine in the treatment of symptomatic cervical spondylosis. The authors suggested that disc degeneration, osteophyte formation and foraminal stenosis resulted in brachalgia. In their series of 14 patients who underwent anterior approach and interbody fusion with autologous iliac crest graft they reported symptomatic improvement.12 In their subsequent article on 55 patients with longer follow-up, which is also one of the top articles, Robinson continued to report good success with the anterior interbody fusion of cervical spine with low complication rates.13 This technique has since become the gold standard for the treatment of cervical spondylosis and cervical myelopathy. In contrast to previous studies where 1980s was the most prolific decade for articles,3 the decades of 1990s saw the most publications in cervical spine surgery. This is similar to papers published in Foot and ankle surgery,4 sports medicine,111 shoulder surgery112 and spine surgery.113 These two decades coincided with the development of improved instrumentation and surgical technique for managing cervical instability and reflect the relatively young field of spinal surgery. In 1992, Jeanneret and Magerl14 (ranked 38) described the trans-articular atlantoaxial screw fixation technique for treating unstable odontoid fractures, which was alternate to the then more popular Gallie15 or Brooks16 type posterior fusion technique which lacked primary stability for treatment of unstable C2 peg fractures. In 2001, Harms and Melcher 17 (ranked 5) described another technique for treating the atlantoaxial joint instability with posterior atlas and axis screw-rod fixation and fusion. Both the Magerl and Harms methods remained popular techniques to date, demonstrating high fusion rate for treating C2 fractures. The decade of 2000-2009 saw an improvement in cervical disc arthroplasty design and increasing use for treating cervical myelopathy or radiculopathy. Goffin et al.18 in 2002 (ranked 45) described their preliminary experience with the Bryan Disc Replacement, reporting on the safety of the device and favorable results at short term follow-up. Proponents of cervical disc arthroplasty argue that maintenance of motion avoids adjacent segment degeneration. More than 15 designs of cervical disc arthroplasty are undergoing ongoing clinical trails to determine its efficacy.19 Cervical fusion was the most popular topic with 36 papers featured in the 100 articles we reviewed. Anterior fusion was the most commonly described technique and is currently the gold standard for treating mid to lower cervical spine disorder ranging from fracture-dislocation, instability and degenerative disc disease. Popularized by Smith and Robinson,12 the technique saw a trend to improve fusion rates through grafting which is the 5th most common topic. Bishop et al.20 (ranked 76) use of allograft and An et al.21 (ranked 66) used allograft plus demineralized bone matrix for anterior cervical fusion but found this not to be superior, with high rates of pseudoarthrosis and graft collapse. More recent interest has been the use of BMP and it’s association with higher complication rates. Interestingly complications as a subject ranked 4th in this study. Published in 2006 and ranked 20, Shields et al.22 reported the adverse effects associated with high-dose recombinant human bone morphogenetic protein-2 use in anterior cervical spine fusion. This was one of the first studies that reported on the adverse events associated with rhBMP-2 in cervical spine surgery, including life threatening events such as delayed haematoma, soft tissue swelling and airway compromise. This is contrary to initial industry sponsored rhBMP-2 on its use reporting a 0% adverse event rate.6 Classification systems and outcome tools have been found in other citation analysis to be prominent features. The top two articles in this analysis are describing classification systems and outcome tools respectively. This shows the importance to have a well validated outcome tool in clinical research as it allows the effect of a treatment to be assessed between studies and allows direct comparison of one technique with another. The most popular journal for publication was the Spine Journal. This highlights its role as a journal for both neurosurgical and orthopaedic spinal surgeons to read. Nearly two thirds of the 100 most cited articles were published in just two journals. The journal of Bone and Joint Surgery, America was the second most popular destination for research. These two journals both have high impact and highlight the need to publish work in a high impact journal. The United States was the country with the most number of articles included in the 100 articles we reviewed. This is similar to results from many previous bibliometric anaylsis papers.3,4,111,112,113 Japan featured as the second most prolific nation and this relates to their role in the development and advancement of the laminoplasty technique for the management of cervical cord compression. All the papers which included randomized trials were published since the year 2000, highlighting an improvement in the quality of research being performed. The papers which were of lower level of evidence all tended to be published earlier. This shows that the quality of research being performed has improved as better understanding of clinical research is developed. The most common level of evidence were 3 and 4 which are similar to other orthopedic bibliometric analysis papers.111,112,113 This highlights the difficulty that we have in surgical specialties in performing good randomized control trials. A similar bibliometric analysis has been published on the cervical spine by Ruegsegger et al.114 They performed a bibliometric analysis using the same database but a different key word search. This we believe is why our independent study results differ to theirs. Their method, we feel, will have resulted in the exclusion of some key articles we included. Previous papers on bibliometric analysis have restricted their analysis to the journals with higher impact factor. We did not restrict our search by this, as it may create a list which excludes key articles. As a result, we feel our citation analysis is more powerful. Some question the use of citation analysis as a scientific tool. We feel these lists are beneficial for junior clinicians and researchers alike as it highlights key features of research and provides a historic account of the developments. Whilst some articles will be highly cited due to their controversial nature however we feel that these are likely to be few compared with those that advance the specialty. Previous papers have highlighted the unfair advantage that ranking by total citations can give an article which has been published for a long time. This can be seen in our comparison of articles by number of citations per year. Carragee et al.6 article has an average citation of 76.6 per year compared with Frankel et al.,7,25,68. We see articles on cervical disc arthroplasty advancing significantly when we rank by average per year. This highlight that these papers are important now and are likely to feature in bibliometric analysis in the future. ## Conclusion This article shows the journals which are likely to provide an author with high levels of readership and potentially high citation. It provides an insight to the development of modern cervical spine surgery. With continued development of surgical implant technology and research methods the features of this list will change to reflect these newer techniques and approaches. This article provides a current insight into the most cited cervical spine papers. ## Disclosures & COI The authors declare no relevant financial disclosures. * Copyright © 2017 ISASS - This manuscript is generously published free of charge by ISASS, the International Society for the Advancement of Spine Surgery ## Reference 1. Steinberger J, Skovrlj B, Caridi JM, Cho SK (2015) The top 100 classic papers in lumbar spine surgery. Spine (Phila Pa 1976) 40(10):740–7. 2. O'Neill SC, Butler JS, McGoldrick N, O'Leary R, Synnott K (2014) The 100 most cited papers in spinal deformity surgery: a bibliometric analysis. Orthop Rev (Pavia) 6(4):5584. 3. Kelly JC, Glynn RW, O'Briain DE, Felle P, Mc-Cabe JP (2010) The 100 classic papers of orthopaedic surgery: a bibliometric analysis. J Bone Joint Surg Br 92(10):1338–43. 4. Bayley M, Brooks F, Tong A, Hariharan K (2014) The 100 most cited papers in foot and ankle surgery. Foot (Edinb) 24(1):11–6. 5. Bailey DK (1952) THE NORMAL CERVICAL SPINE IN INFANTS AND CHILDREN. Radiology 59(5):712–9. 6. Carragee EJ, Hurwitz EL, Weiner BK (2011) A critical review of recombinant human bone morphogenetic protein-2 trials in spinal surgery: emerging safety concerns and lessons learned. Spine Journal 11(3), (6):471–91. 7. Frankel HL, Hancock DO, Hyslop G, Melzak J, Michaelis LS, Ungar GH, et al. (1969) The value of postural reduction in the initial management of closed injuries of the spine with paraplegia and tetraplegia. I. Paraplegia 7(3):179–92. 8. Kirshblum SC, Biering-Sorensen F, Betz R, Burns S, Donovan W, Graves DE, et al. (2014) International standards for neurological classification of spinal cord injury: cases with classification challenges. Top Spinal Cord Inj Rehabil 20(2):81–9. 9. Vernon H, Mior S (1991) THE NECK DISABILITY INDEX - A STUDY OF RELIABILITY AND VALIDITY. J Manip Physiol Ther 14(7):409–15. 10. Fairbank JC, Couper J, Davies JB, O'Brien JP (1980) The Oswestry low back pain disability questionnaire. Physiotherapy 66(8):271–3. 11. Vernon H (2008) The Neck Disability Index: state-ofthe-art, 1991-2008. J Manipulative Physiol Ther 31(7):491–502. 12. Smith GW, Robinson RA (1958) THE TREATMENT OF CERTAIN CERVICAL-SPINE DISORDERS BY ANTERIOR REMOVAL OF THE INTERVERTEBRAL DISC AND INTERBODY FUSION. J Bone Joint Surg-Am Vol 40(3):607–24. 13. Robinson RA, Walker AE, Ferlic DC, Wiecking DK (1962) THE RESULTS OF ANTERIOR INTERBODY FUSION OF THE CERVICAL SPINE. J Bone Joint Surg-Am Vol 44(8):1569–87. 14. Jeanneret B, Magerl F (1992) PRIMARY POSTERIOR FUSION-C1/2 IN ODONTOID FRACTURES - INDICATIONS, TECHNIQUE, AND RESULTS OF TRANSARTICULAR SCREW FIXATION. J Spinal Disord 5(4):464–75. 15. WE G (1939) Fractures and dislocations of the cervical spine. Am J Surg (46):495–9. 16. Brooks AL, Jenkins EB (1978) Atlanto-axial arthrodesis by the wedge compression method. J Bone Joint Surg Am 60(3):279–84. 17. Harms J, Melcher RP (2001) Posterior C1-C2 fusion with polyaxial screw and rod fixation. Spine 26(22):2467–71. 18. Goffin J, Casey A, Kehr P, Liebig K, Lind B, Logroscino C, et al. (2002) Preliminary clinical experience with the Bryan Cervical Disc Prosthesis. Neurosurgery 51(3):840–5. 19. Orr RD, Postak PD, Rosca M, Greenwald AS (2007) The current state of cervical and lumbar spinal disc arthroplasty. J Bone Joint Surg Am 89(Suppl 3):70–5. 20. Bishop RC, Moore KA, Hadley MN (1996) Anterior cervical interbody fusion using autogeneic and allogeneic bone graft substrate: A prospective comparative analysis. J Neurosurg 85(2):206–10. 21. An HS, Simpson JM, Glover JM, Stephany J (1995) COMPARISON BETWEEN ALLOGRAFT PLUS DEMINERALIZED BONE-MATRIX VERSUS AUTOGRAFT IN ANTERIOR CERVICAL FUSION - A PROSPECTIVE MULTICENTER STUDY. Spine 20(20):2211–6. 22. Shields LBE, Raque GH, Glassman SD, Campbell M, Vitaz T, Harpring J, et al. (2006) Adverse effects associated with high-dose recombinant human bone morphogenetic protein-2 use in anterior cervical spine fusion. Spine 31(5):542–7. 23. Hilibrand AS, Carlson GD, Palumbo MA, Jones PK, Bohlman HH (1999) Radiculopathy and myelopathy at segments adjacent to the site of a previous anterior cervical arthrodesis. J Bone Joint Surg-Am Vol 81A(4):519–28. 24. Hoffman JR, Mower WR, Wolfson AB, Todd KH, Zucker MI, Natl Emergency XRUSG (2000) Validity of a set of clinical criteria to rule out injury to the cervical spine in patients with blunt trauma. N Engl J Med 343(2):94–9. 25. Silber JS, Anderson DG, Daffner SD, Brislin BT, Leland JM, Hilibrand AS, et al. (2003) Donor site morbidity after anterior iliac crest bone harvest for single-level anterior cervical discectomy and fusion. Spine 28(2):134–9. 26. Bohlman HH, Emery SE, Goodfellow DB, Jones PK (1993) ROBINSON ANTERIOR CERVICAL DISKECTOMY AND ARTHRODESIS FOR CERVICAL RADICULOPATHY - LONG-TERM FOLLOW-UP OF 100 AND 22 PATIENTS. J Bone Joint Surg-Am Vol 75A(9):1298–307. 27. Boden SD, McCowin PR, Davis DO, Dina TS, Mark AS, Wiesel S (1990) ABNORMAL MAGNETICRESONANCE SCANS OF THE CERVICALSPINE IN ASYMPTOMATIC SUBJECTS - A PROSPECTIVE INVESTIGATION. J Bone Joint Surg-Am Vol 72A(8):1178–84. 28. Bohlman HH (1979) ACUTE FRACTURES AND DISLOCATIONS OF THE CERVICAL-SPINE - ANALYSIS OF 300 HOSPITALIZED-PATIENTS AND REVIEW OF THE LITERATURE. J Bone Joint Surg-Am Vol 61(8):1119–42. 29. Stiell IG, Wells GA, Vandemheen KL, Clement CM, Lesiuk H, De Maio VJ, et al. (2001) The Canadian C-spine rule for radiography in alert and stable trauma patients. JAMA-J Am Med Assoc 286(15):1841–8. 30. Ranawat CS, Oleary P, Pellicci P, Tsairis P, Marchisello P, Dorr L (1979) CERVICAL-SPINE FUSION IN RHEUMATOID-ARTHRITIS. J Bone Joint Surg-Am Vol 61(7):1003–10. 31. Resnick D, Niwayama G (1976) RADIOGRAPHIC AND PATHOLOGIC FEATURES OF SPINAL INVOLVEMENT IN DIFFUSE IDIOPATHIC SKELETAL HYPEROSTOSIS (DISH). Radiology 119(3):559–68. 32. Bailey RW, Badgley CE (1960) STABILIZATION OF THE CERVICAL SPINE BY ANTERIOR FUSION. J Bone Joint Surg-Am Vol 42(4):565–94. 33. Bovim G, Schrader H, Sand T (1994) NECK PAIN IN THE GENERAL-POPULATION. Spine 19(12):1307–9. 34. Hirabayashi K, Watanabe K, Wakano K, Suzuki N, Satomi K, Ishii Y (1983) EXPANSIVE OPEN-DOOR LAMINOPLASTY FOR CERVICAL SPINAL STENOTIC MYELOPATHY. Spine 8(7):693–9. 35. Payne EE, Spillane JD (1957) THE CERVICAL SPINE - AN ANATOMICO-PATHOLOGICAL STUDY OF 70 SPECIMENS (USING A SPECIAL TECHNIQUE) WITH PARTICULAR REFERENCE TO THE PROBLEM OF CERVICAL SPONDYLOSIS. Brain 80(4):571–96. 36. Schneider RC, Cherry G, Pantek H (1954) THE SYNDROME OF ACUTE CENTRAL CERVICAL SPINAL CORD INJURY - WITH SPECIAL REFERENCE TO THE MECHANISMS INVOLVED IN HYPEREXTENSION INJURIES OF CERVICAL SPINE. J Neurosurg 11(3), (6):546–77. 37. Eck JC, Humphreys SC, Lim TH, Jeong ST, Kim JG, Hodges SD, et al. (2002) Biomechanical study on the effect of cervical spine fusion on adjacent-level intradiscal pressure and segmental motion. Spine 27(22):2431–4. 38. Barnsley L, Lord S, Bogduk N (1994) WHIPLASH INJURY. Pain 58(3):283–307. 39. Allen BL, Ferguson RL, Lehmann TR, Obrien RP (1982) A MECHANISTIC CLASSIFICATION OF CLOSED, INDIRECT FRACTURES AND DISLOCATIONS OF THE LOWER CERVICALSPINE. Spine 7(1):1–27. 40. Wright NM, Lauryssen C (1998) Vertebral artery injury in C1-2 transarticular screw fixation: Results of a survey of the AANS/CNS section on disorders of the spine and peripheral nerves. J Neurosurg 88(4):634–40. 41. Pang D, Wilberger JE (1982) SPINAL-CORD INJURY WITHOUT RADIOGRAPHIC ABNORMALITIES IN CHILDREN. J Neurosurg 57(1):114–29. 42. Schrader H, Obelieniene D, Bovim G, Surkiene D, Mickeviciene D, Miseviciene I, et al. (1996) Natural evolution of late whiplash syndrome outside the medicolegal context. Lancet 347(9010):1207–11. 43. Sen CN, Sekhar LN (1990) AN EXTREME LATERAL APPROACH TO INTRADURAL LESIONS OF THE CERVICAL-SPINE AND FORAMEN MAGNUM. Neurosurgery 27(2):197–204. 44. Jones EL, Heller JG, Silcox DH, Hutton WC (1997) Cervical pedicle screws versus lateral mass screws - Anatomic feasibility and biomechanical comparison. Spine 22(9):977–82. 45. Abumi K, Shono Y, Ito M, Taneichi H, Kotani Y, Kaneda K (2000) Complications of pedicle screw fixation in reconstructive surgery of the cervical spine. Spine 25(8):962–9. 46. Gore DR, Sepic SB, Gardner GM (1986) ROENTGENOGRAPHIC FINDINGS OF THE CERVICAL-SPINE IN ASYMPTOMATIC PEOPLE. Spine 11(3), (6):521–4. 47. Panjabi MM, Duranceau J, Goel V, Oxland T, Takata K (1991) CERVICAL HUMAN VERTEBRAE - QUANTITATIVE 3-DIMENSIONAL ANATOMY OF THE MIDDLE AND LOWER REGIONS. Spine 16(8):861–9. 48. Radanov BP, Sturzenegger M, Distefano G (1995) LONG-TERM OUTCOME AFTER WHIPLASH INJURY - A 2-YEAR FOLLOW-UP CONSIDERING FEATURES OF INJURY MECHANISM AND SOMATIC, RADIOLOGIC, AND PSYCHOSOCIAL FINDINGS. Medicine 74(5):281–97. 49. Grob D, Jeanneret B, Aebi M, Markwalder TM (1991) ATLANTOAXIAL FUSION WITH TRANSARTICULAR SCREW FIXATION. J Bone Joint Surg-Br Vol 73(6):972–6. 50. Hurwitz EL, Aker PD, Adams AH, Meeker WC, Shekelle PG (1996) Manipulation and mobilization of the cervical spine - A systematic review of the literature. Spine 21(15):1746–59. 51. Kotani Y, Cunningham BW, Abumi K, McAfee PC (1994) BIOMECHANICAL ANALYSIS OF CERVICAL STABILIZATION SYSTEMS - AN ASSESSMENT OF TRANSPEDICULAR SCREW FIXATION IN THE CERVICAL-SPINE. Spine 19(22):2529–39. 52. Jull G, Trott P, Potter H, Zito G, Niere K, Shirley D, et al. (2002) A randomized controlled trial of exercise and manipulative therapy for cervicogenic headache. Spine 27(17):1835–43. 53. Sambrook PN, MacGregor AJ, Spector TD (1999) Genetic influences on cervical and lumbar disc degeneration - A magnetic resonance imaging study in twins. Arthritis Rheum 42(2):366–72. 54. Penning L (1978) NORMAL MOVEMENTS OF CERVICAL-SPINE. Am J Roentgenol 130(2):317–26. 55. Ylinen J, Takala EP, Nykanen M, Hakkinen A, Malkia E, Pohjolainen T, et al. (2003) Active neck muscle training in the treatment of chronic neck pain in women - A randomized controlled trial. JAMA-J Am Med Assoc 289(19):2509–16. 56. Davis JW, Phreaner DL, Hoyt DB, Mackersie RC (1993) THE ETIOLOGY OF MISSED CERVICALSPINE INJURIES. J Trauma-Injury Infect Crit Care 34(3):342–6. 57. Mummaneni PV, Burkus JK, Haid RW, Traynelis VC, Zdeblick TA (2007) Clinical and radiographic analysis of cervical disc arthroplasty compared with allograft fusion: a randomized controlled clinical trial. J Neurosurg-Spine 6(3):198–209. 58. Fang HSY, Ong GB (1962) DIRECT ANTERIOR APPROACH TO THE UPPER CERVICAL SPINE. J Bone Joint Surg-Am Vol 44(8):1588–604. 59. Goffin J, Van Calenbergh F, van Loon J, Casey A, Kehr P, Liebig K, et al. (2003) Intermediate follow-up after treatment of degenerative disc disease with the Bryan Cervical Disc Prosthesis: Single-level and bilevel. Spine 28(24):2673–8. 60. Teresi LM, Lufkin RB, Reicher MA, Moffit BJ, Vinuela FV, Wilson GM, et al. (1987) ASYMPTOMATIC DEGENERATIVE DISK DISEASE AND SPONDYLOSIS OF THE CERVICAL-SPINE - MR IMAGING. Radiology 164(1):83–8. 61. Abumi K, Itoh H, Taneichi H, Kaneda K (1994) TRANSPEDICULAR SCREW FIXATION FOR TRAUMATIC LESIONS OF THE MIDDLE AND LOWER CERVICAL-SPINE - DESCRIPTION OF THE TECHNIQUES AND PRELIMINARYREPORT. J Spinal Disord 7(1):19–28. 62. Conlon PW, Isdale IC, Rose BS (1966) RHEUMATOID ARTHRITIS OF CERVICAL SPINE - AN ANALYSIS OF 333 CASES. Ann Rheum Dis 25(2):120–6. 63. Rogers WA (1957) FRACTURES AND DISLOCATIONS OF THE CERVICAL SPINE - AN ENDRESULT STUDY. J Bone Joint Surg-Am Vol 39(2):341–76. 64. Emery SE, Bohlman HH, Bolesta MJ, Jones PK (1998) Anterior cervical decompression and arthrodesis for the treatment of cervical spondylotic myelopathy - Two to seventeen-year follow-up. J Bone Joint Surg-Am Vol 80A(7):941–51. 65. Vaccaro AR, Falatyn SP, Scuderi GJ, Eismont FJ, McGuire RA, Singh K, et al. (1998) Early failure of long segment anterior cervical plate fixation. J Spinal Disord 11(3), (5):410–5. 66. Youdas JW, Carey JR, Garrett TR (1991) RELIABILITY OF MEASUREMENTS OF CERVICALSPINE RANGE OF MOTION - COMPARISON OF 3 METHODS. Phys Ther 71(2):98–104. 67. Southwick WO, Robinson RA (1957) SURGICAL APPROACHES TO THE VERTEBRAL BODIES IN THE CERVICAL AND LUMBAR REGIONS. J Bone Joint Surg-Am Vol 39(3):631–44. 68. Buskila D, Neumann L, Vaisberg G, Alkalay D, Wolfe F (1997) Increased rates of fibromyalgia following cervical spine injury - A controlled study of 161 cases of traumatic injury. Arthritis Rheum 40(3):446–52. 69. Goffin J, Geusens E, Vantomme N, Quintens E, Waerzeggers Y, Depreitere B, et al. (2004) Long-term follow-up after interbody fusion of the cervical spine. J Spinal Disord Tech 17(2):79–85. 70. Stiell IG, Clement CM, McKnight RD, Brison R, Schull MJ, Rowe BH, et al. (2003) The canadian C-spine rule versus the NEXUS low-risk criteria in patients with trauma. N Engl J Med 349(26):2510–8. 71. Flanders AE, Schaefer DM, Doan HT, Mishkin MM, Gonzalez CF, Northrup BE (1990) ACUTE CERVICAL-SPINE TRAUMA - CORRELATION OF MR IMAGING FINDINGS WITH DEGREE OF NEUROLOGIC DEFICIT. Radiology 177(1):25–33. 72. Sawin PD, Traynelis VC, Menezes AH (1998) A comparative analysis of fusion rates and donor-site morbidity for autogeneic rib and iliac crest bone grafts in posterior cervical fusions. J Neurosurg 88(2):255–65. 73. Clark CR, White AA (1985) FRACTURES OF THE DENS - A MULTICENTER STUDY. J Bone Joint Surg-Am Vol 67A(9):1340–8. 74. Cattell HS, Filtzer DL (1965) PSEUDOSUBLUXATION AND OTHER NORMAL VARIATIONS IN CERVICAL SPINE IN CHILDREN. A STUDY OF 160 CHILDREN. J Bone Joint Surg-Am Vol A 47(7):1295–309. 75. Fountas KN, Kapsalaki EZ, Nikolakakos LG, Smisson HF, Johnston KW, Grigorian AA, et al. (2007) Anterior cervical Discectomy and fusion associated complications. Spine 32(21):2310–7. 76. Kaiser MG, Haid RW, Subach BR, Barnes B, Rodts GE (2002) Anterior cervical plating enhances arthrodesis after discectomy and fusion with cortical allograft. Neurosurgery 50(2):229–36. 77. Levine AM, Edwards CC (1985) THE MANAGEMENT OF TRAUMATIC SPONDYLOLISTHESIS OF THE AXIS. J Bone Joint Surg-Am Vol 67A(2):217–25. 78. Wada E, Suzuki S, Kanazawa A, Matsuoka T, Miyamoto S, Yonenobu K (2001) Subtotal corpectomy versus laminoplasty for multilevel cervical spondylotic myelopathy - A long-term follow-up study over 10 years. Spine 26(13):1443–7. 79. Smucker JD, Rhee JM, Singh K, Yoon ST, Heller JG (2006) Increased swelling complications associated with off-label usage of rhBMP-2 in the anterior cervical spine. Spine 31(24):2813–9. 80. Boden SD, Dodge LD, Bohlman HH, Rechtine GR (1993) RHEUMATOID-ARTHRITIS OF THE CERVICAL-SPINE - A LONG-TERM ANALYSIS WITH PREDICTORS OF PARALYSIS AND RECOVERY. J Bone Joint Surg-Am Vol 75A(9):1282–97. 81. Murrey D, Janssen M, Delamarter R, Goldstein J, Zigler J, Tay B, et al. (2009) Results of the prospective, randomized, controlled multicenter Food and Drug Administration investigational, device exemption study of the ProDisc-C total disc replacement versus anterior discectomy and fusion for the treatment of 1-level symptomatic cervical disc disease. Spine Journal 9(4):275–86. 82. Hosono N, Yonenobu K, Ono K (1996) Neck and shoulder pain after laminoplasty - A noticeable complication. Spine 21(17):1969–73. 83. Bazaz R, Lee MJ, Yoo JU (2002) Incidence of dysphagia after anterior cervical spine surgery - A prospective study. Spine 27(22):2453–8. 84. Vasavada AN, Li SP, Delp SL (1998) Influence of muscle morphometry and moment arms on the moment-generating capacity of human neck muscles. Spine 23(4):412–22. 85. Dickman CA, Sonntag VKH, Papadopoulos SM, Hadley MN (1991) THE INTERSPINAL METHOD OF POSTERIOR ATLANTOAXIAL ARTHRODESIS. J Neurosurg 74(2):190–8. 86. Panjabi MM, Crisco JJ, Vasavada A, Oda T, Cholewicki J, Nibu K, et al. (2001) Mechanical properties of the human cervical spine as shown by three-dimensional load-displacement curves. Spine 26(24):2692–700. 87. Aker PD, Gross AR, Goldsmith CH, Peloso P (1996) Conservative management of mechanical neck paIn: Systematic overview and meta-analysis. Br Med J 313(7068):1291–6. 88. Itoh T, Tsuji H (1985) TECHNICAL IMPROVEMENTS AND RESULTS OF LAMINOPLASTY FOR COMPRESSIVE MYELOPATHY IN THE CERVICAL-SPINE. Spine 10(8):729–36. 89. Pellicci PM, Ranawat CS, Tsairis P, Bryan WJ (1981) A PROSPECTIVE-STUDY OF THE PROGRESSION OF RHEUMATOID-ARTHRITIS OF THE CERVICAL-SPINE. J Bone Joint Surg-Am Vol 63(3):342–50. 90. Abumi K, Takada T, Shono Y, Kaneda K, Fujiya M (1999) Posterior occipitocervical reconstruction using cervical pedicle screws and plate-rod systems. Spine 24(14):1425–34. 91. Heller JG, Sasso RC, Papadopoulos SM, Anderson PA, Fessler RG, Hacker RJ, et al. (2009) Comparison of BRYAN Cervical Disc Arthroplasty With Anterior Cervical Decompression and Fusion Clinical and Radiographic Results of a Randomized, Controlled, Clinical Trial. Spine 34(2):101–7. 92. Abumi K, Kaneda K (1997) Pedicle screw fixation for nontraumatic lesions of the cervical spine. Spine 22(16):1853–63. 93. Melcher RP, Puttlitz CM, Kleinstueck FS, Lotz JC, Harms J, Bradford DS (2002) Biomechanical testing of posterior atlantoaxial fixation techniques. Spine 27(22):2435–40. 94. Katsuura A, Hukuda S, Saruhashi Y, Mori K (2001) Kyphotic malalignment after anterior cervical fusion is one of the factors promoting the degenerative process in adjacent intervertebral levels. Eur Spine J 10(4):320–4. 95. Perry J, Nickel VL (1959) TOTAL CERVICAL-SPINE FUSION FOR NECK PARALYSIS. J Bone Joint Surg-Am Vol 41(1):37–60. 96. Matsumoto M, Fujimura Y, Suzuki N, Nishi Y, Nakamura M, Yabe Y, et al. (1998) MRI of cervical intervertebral discs in asymptomatic subjects. J Bone Joint Surg-Br Vol 80B(1):19–24. 97. Johnson RM, Hart DL, Simmons EF, Ramsby GR, Southwick WO (1977) CERVICAL ORTHOSES - STUDY COMPARING THEIR EFFECTIVENESS IN RESTRICTING CERVICAL MOTION IN NORMAL SUBJECTS. J Bone Joint Surg-Am Vol 59(3):332–9. 98. Richter M, Schmidt R, Claes L, Puhl W, Wilke HJ (2002) Posterior atlantoaxial fixation - Biomechanical in vitro comparison of six different techniques. Spine 27(16):1724–32. 99. Bogduk N, Mercer S (2000) Biomechanics of the cervical spine. I: Normal kinematics. Clin Biomech 15(9):633–48. 100.Gore DR, Sepic SB, Gardner GM, Murray MP (1987) NECK PAIN - A LONG-TERM FOLLOW-UP OF 205 PATIENTS. Spine 12(1):1–5. 101.Torg JS, Pavlov H, Genuario SE, Sennett B, Wisneski RJ, Robie BH, et al. (1986) NEURAPRAXIA OF THE CERVICAL SPINAL-CORD WITH TRANSIENT QUADRIPLEGIA. J Bone Joint Surg-Am Vol 68A(9):1354–70. 102.Sakaura H, Hosono N, Mukai Y, Ishii T, Yoshikawa H (2003) C5 palsy after decompression surgery for cervical myelopathy - Review of the literature. Spine 28(21):2447–51. 103.Wang JC, McDonough PW, Endow KK, Delamarter RB (2000) Increased fusion rates with cervical plating for two-level anterior cervical discectomy and fusion. Spine 25(1):41–5. 104.Matsunaga S, Kabayama S, Yamamoto T, Yone K, Sakou T, Nakanishi K (1999) Strain on intervertebral discs after anterior cervical decompression and fusion. Spine 24(7):670–5. 105.Wainner RS, Fritz JM, Irrgang JJ, Boninger ML, Delitto A, Allison S (2003) Reliability and diagnostic accuracy of the clinical examination and patient self-report measures for cervical radiculopathy. Spine 28(1):52–62. 106.Coe JD, Warden KE, Sutterlin CE, McAfee PC (1989) BIOMECHANICAL EVALUATION OF CERVICAL SPINAL STABILIZATION METHODS IN A HUMAN CADAVERIC MODEL. Spine 14(10):1122–31. 107.Tan MS, Wang HM, Wang YT, Zhang GB, Yi P, Li ZR, et al. (2003) Morphometric evaluation of screw fixation in atlas via posterior arch and lateral mass. Spine 28(9):888–95. 108.Resnick DK, Lapsiwala S, Trost GR (2002) Anatomic suitability of the C1-C2 complex for pedicle screw fixation. Spine 27(14):1494–8. 109.Resnick DK, Benzel EC (2002) C1-C2 pedicle screw fixation with rigid cantilever beam construct: Case report and technical note. Neurosurgery 50(2):426–8. 110.Hacker RJ, Cauthen JC, Gilbert TJ, Griffith SL (2000) A prospective randomized multicenter clinical evaluation of an anterior cervical fusion cage. Spine 25(20):2646–54. 111.Nayer Sk, Dein Ej, Spiker AM, Bernard JA, Zikira BA (Aug, 2015) The top 100 cited articles in Clinical Orthopedic sports medicine. Am j Orthop 44(8):E252–61. 112.Namdari S, Baldwin K, Kovatch K, Huffman GR, Glaser D (2012) Fifty most cited articles in orthopedic shoulder surgery. J Shoulder Elbow Srg 21:1796–1802. 113.Murray MR, Wang T, Schroeder GD, Hsu WK (2012) The 100 most cited spine articles. Eur Spine J 21(10):2059–2069. 114.Ruegsegger N, Ahmad SS, Benneker LM, et al. (2016) The 100 most influential publications in cervical spine research. Spine 41(6):538–548.