The 20 most influential papers produced in the past decade by seven major spinal journals on both altmetric and bibliometric databases

Bibliometric versus altmetric analysis. This study aims to compare the top 20 altmetric articles versus the top 20 bibliometric measures published over the past decade in the world’s top spine journals. The following is hypothesised: 1) The articles in each list will be different; 2) each list will present varying levels of evidence; and 3) each list will reflect distinct geographic and demographic distributions. Altmetric Explorer and Web of Science were searched on 4 October 2024 for articles published between 2014–2023 in seven leading spine journals. The top 20 articles by AAS and by citation count were identified. Article type, level of evidence (LOE), citation density, and geographic and demographic engagement were analysed. No articles overlapped between the two lists. Altmetric articles were mentioned 7,530 times across 107 countries, had a mean citation density of 11.4. Whereas, the bibliometric articles were cited 7,013 times with a mean citation density of 47.5 and only 1010 mentions. Altmetric articles included more level I–II studies (7 vs 1) and were more geographically diverse, with greater representation from developing regions. Altmetric analysis identified articles with higher LOE and broader dissemination than traditional citation-based metrics. Combining both methods provides a more balanced understanding of research impact in spine surgery.