Abstract
Introduction
Although the ancient Egyptian Imhotep was the first to report a document on spinal injuries, the Edwin Smith Papyrus dating 3000–2500 BC, actual contribution of Arab spinal surgeons to spine research is limited. The aim of this study was to assess the contribution of Arab spine surgeons to spine research in the last two decades.
Methods
A systemic review of PubMed/Medline including spine-related articles published in journals specialized for spine, orthopaedics and traumatology or neurosurgery, since 1985. Journals focusing mainly on radiology, physical medicine, general medicine, general surgery and others have been excluded. Articles published before the end of July 2015 have been included. At least one affiliation or one author must be based in one of the 22 Arab countries. Bibliometric analysis of the number of articles published from each country, type of study, institution, impact factor (JCR 2014) and trend of publications frequency over 20 years. Quality of publications was assessed by number of citations and level of evidence of clinical studies (LOE).
Results
The review revealed 445 articles; 66 of them have been excluded being published in non spine-related journals, as well as 10 letters to the editors. Of 369 remaining publications, 115 were case reports with a mean of 1.32 citations/case report, mostly originated from Morocco (38), Lebanon (24), Saudi Arabia and Tunisia (14). The remaining 254 original articles have been analyzed; most frequently clinical studies (228 articles). Of these, 8 articles have been published in German and 5 in French. Spine was the favorite journal of Arab scientists with 47 publications, followed by ESJ with 32, ASJ, International Orthopaedics and Bone Joint Spine with 14 articles each. Articles published in Spine were also most frequently cited, 4.89 times on average, Bone Joint Spine 3.43 and ESJ 3.41 citations/article. Most of publications originated from the university: 192 articles, followed by public hospitals with 36 articles, military hospitals 13 and private sector with 13 articles. Egyptian authors published 120, Saudis 35 and Lebanese 32 articles. Institutionally, University of Alexandria published highest number of spine-related articles; 40, followed by Cairo University with 38, the American University in Beirut 16 and Assiut University 14 Articles. Of original articles, a mean of 2.47 citations/article has been calculated. Studies with LOE I had a mean of 5.25 citations/article. Publications from non-surgical departments had a higher citation rate than surgical departments. Tunisian publications have highest rate of citations/article: 4, followed by Kuwait 3,75 and Saudi Arabia 3.71. Riyadh-based publications have been cited 4.94 times in average, followed by those from Kuwait City 3.75 and Jeddah 3.6 citations/article.
Conclusion
The Trend is a progressively increasing contribution of Arab spinal researchers to the global spine research over the last two decades. It is not only the absolute number of published articles but also the percentage related to the global research is increasing. Institutions should emphasize the importance and increase awareness of researches about the value of peer-reviewed publications.