The objective of this study was to identify and review the most-cited articles on spinal cord injury (SCI). Citation analyses showcase the relative influence of individual articles in a given field. In addition to distinguishing publications of particular quality and impact and well-developed areas of the literature, citation analyses allow for an understanding of the direction in which a field of research is headed. A multi-disciplinary bibliographic index was used to identify the 50 SCI articles with the most lifetime citations, and the 50 SCI articles with the highest annual citation rates. Studies were categorized into one of six categories based on their primary focus: treatment, pathology/natural history, predictor of outcome, methods, epidemiology, or assessment measure. We report that 40.0 and 56.0% of SCI papers with the most lifetime citations and highest annual citation rates, respectively, were systematic reviews or meta-analyses, indicating that some of the most referenced papers in SCI are not primary publications. Further, there appears to be a greater international presence in SCI research. In the highest annual citation rate cohort, 14.0% of papers were a product of international collaboration, 50.0% were published by outside of the United States, and the average year of publication was 2005±5.4; the comparable numbers for papers that comprised the highest lifetime citation cohort were, respectively, 8.0, 28.0%, and 1998±9.2. Treatment and pathology/natural history of SCI were a common research focus in both citation cohorts, consistent with ongoing efforts to better understand and manage this injury. This comprehensive review provides a cross-sectional summary and bibliometric analysis of some of the most influential literature in SCI, and compliments existing systematic reviews and meta-analysis in the field by establishing which areas of the literature are growing and which have been well developed.
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