The top 100 most cited peer-reviewed publications on global neurosurgery: Mapping research trends and gaps over four decades

This study aimed to highlight the landscape of global neurosurgery (GNS) literature through a bibliometric analysis of the 100 most cited peer-reviewed publications. The objectives were to identify publication trends, citation patterns, authorship, and collaboration networks within GNS research over the past four decades. A comprehensive search was conducted using Google Scholar and the Web of Science (WoS) database to identify articles related to GNS published within the last 40 years. The top 100 most cited articles were selected for analysis. Bibliometric evaluation was performed using VOSviewer and the Bibliometrix package in RStudio to assess trends in publication, authorship, citation, and country contribution, including those from lower-middle-income and low-income countries (LMIC/LIC). The 100 most-cited GNS publications, spanning 2000–2023, included 811 co-authors from 61 countries and were published across 40 journals, with 71% appearing in nine leading journals. Publication output after 2012 accounted for 68% and showed a significant increase compared to the previous period (χ2 = 12.96, p = 0.00032) The cumulative growth in publications was also significant (χ2 = 27.93, p = 0.00049), driven largely by authors based in the US (χ2 = 92.59, p = 3.7 × 10⁻19) and other high-income countries (χ2 = 44.23, p = 5.7 × 10⁻⁹). 50% of publications originated from the US, while only 9% were from LMIC/LIC. Subspecialty-focused research comprised 76% of papers, with trauma (31%) and pediatric neurosurgery (21%) being the most frequent topics. Among general GNS themes, surgical access (11%) and workforce/education and training (11%) predominated. Co-authorship analysis demonstrated extensive international collaboration, with an overall collaborative rate of 81%. This study provides a comprehensive overview of the evolution and distribution of leading GNS research. The steady rise in publications underscores increasing world-wide engagement in addressing disparities in neurosurgical care. However, persistent underrepresentation from LMIC/LIC highlights a growth opportunity. Strengthening inclusive global partnerships and research capacity in resource-constrained settings will be essential to advance sustainability and overall GNS goals.