Abstract: BACKGROUND: In recent years, the rapid development of emerging technologies such as stem cells, exosomes, and biomaterials has provided diversified approaches and feasibility for the realization of intervertebral disc regeneration therapies.
OBJECTIVE: To conduct a bibliometric visualization analysis of research hotspots in the field of intervertebral disc regeneration and repair, summarize the developmental trajectory, current status, and research hotspots in this domain, thereby providing a reference for future research.
METHODS: By selecting the Web of Science Core Collection database and utilizing Citespace 6.4.R1 and VOSviewer 1.6.20 software, a comprehensive analysis was performed on relevant countries, institutions, keyword co-occurrence, clustering analysis, burst analysis, timeline analysis, document co-citation analysis, citation burst analysis, and scientific collaboration networks. Visualization techniques were employed to reveal the knowledge structure, academic communities, and technological evolution trends in this research field, thereby forming a comprehensive and objective understanding of the research status and frontier dynamics in intervertebral disc repair and regeneration.
RESULTS AND CONCLUSION: (1) A total of 1 229 articles were included, and the number of publications related to this field has shown an overall increasing trend over the past 15 years. The annual number of publications reaches a peak of 163 in 2023. China is the country with the highest number of publications, contributing 687 articles, while Shanghai Jiao Tong University is the leading institution with 61 publications. Author collaboration analysis reveals that James C. Iatridis from the Icahn School of Medicine at Mount Sinai in the United States ranks first in both publication volume and citation count, with 33 publications, averaging 50.54 citations per article. The author collaboration network indicates that despite regional differences in intervertebral disc regeneration and repair research, the number of international collaborations is significant. (2) Co-citation analysis identified the most cited article as one by Nebojsa Nick Knezevic published in Lancet in 2021, which was cited 61 times. Among the top 10 most co-cited articles, six focus on stem cells, endogenous repair cells, and tissue engineering. In the top 10 articles ranked by citation burst strength, three concentrate on stem cell therapy for intervertebral disc degeneration, while four focus on tissue engineering biomaterials, including hydrogels and biological scaffolds. (3) Keyword co-occurrence and cluster analysis revealed four main research directions: Intervertebral disc structure and tissue engineering (15 items), mechanisms of intervertebral disc degeneration (13 items), establishment of research models and treatment strategies for intervertebral disc degeneration (5 items), and stem cells and regenerative medicine (5 items). The analysis suggests that current research in intervertebral disc repair primarily focuses on treatments aimed at delaying or reversing the progression of disc degeneration. (4) In the top 20 keywords ranked by burst strength, “oxidative stress” exhibited the highest burst intensity. Keywords such as “pathway,” “stress,” “nucleus pulposus cells,” “oxidative stress,” “inflammation,” and “extracellular vesicles” continue to show active bursts, indicating that these areas remain recent research hotspots. Timeline analysis of keywords shows that “oxidative stress” has long been a focal point in intervertebral disc repair and regeneration research. In contrast, “exosomes” have emerged as a new research direction only in recent years. Research on “mesenchymal stem cells,” “annulus fibrosus repair,” and “tissue engineering” has been established earlier and remains a key focus in the field. (5) Through visualization analysis, the field of intervertebral disc repair and regeneration has shown rapid global development. Current technological advancements are primarily reflected in the diversified exploration of regeneration and repair methods. Additionally, researchers have proposed various innovative approaches targeting the mechanisms of intervertebral disc degeneration, demonstrating the broad prospects for future therapeutic methods in this field. 

Key words: intervertebral disc degeneration, intervertebral disc repair, annulus fibrosus repair, bibliometrics, visualization analysis, research hotspots