I've tried to substitute $x = 2 \cosh(t)$ but it ended up: $$\frac 12\int(\operatorname{sech}t-\operatorname{sech}^3 t)\,dt$$
I can solve $\int\operatorname{sech} t\,dt$ but $\int\operatorname{sech}^3 t\,dt$ really kills me.
Or maybe I'm so frustrated I can't continue.
set $\sqrt{x^2-4}=y, x^2=y^2+4, x\ dx=y\ dy$
$$I=\int\dfrac{\sqrt{x^2-4}\cdot x\ dx}{x^4}=\int\dfrac{y^2\ dy}{(y^2+4)^2}$$
Now integrate by parts $$I=y\int\dfrac{y\ dy}{(y^2+4)^2}-\int\left(\dfrac{dy}{dy}\int\dfrac{y\ dy}{(y^2+4)^2}\right)dy$$
Alternatively $x=2\sec t$
$$I=\int\dfrac{2\tan t}{(2\sec t)^3}\cdot2\sec t\tan t\ dt=\dfrac12\int\sin^2tdt=\dfrac14\int(1-\cos2t)dt=?$$