Global Trends in the Neurosurgical Literature: A 20-Year Bibliometric Analysis by Country Income Group

Despite a 4-fold increase in publication volume and rising international collaboration, neurosurgical research remains heavily dominated by HICs. While authorship equity has modestly improved over the past 2 decades, disparities remain stark, especially for LICs. These findings highlight the need for targeted, sustainable efforts to promote equitable research partnerships, capacity building, and lower-middle-income country leadership in global neurosurgery.