The current landscape of United States global neurosurgery scholarly work: gaps and opportunities
Tirone Young1, Sophie Epstein1, Mehek Dedhia1
1Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, The Mount Sinai Medical Center, One Gustave Levy Place- Box 1135, New York, NY, 10029, USA.
Introduction:
Global neurosurgery (GNS) has emerged as a field dedicated at addressing disparities in neurosurgical access, training, and workforce distribution worldwide. Persistent inequities adversely affect population health outcomes contributing to preventable morbidity and mortality. Addressing these gaps is an essential component of universal health coverage and United Nations Sustainable Development Goal 3 (SDG3). This study aimed to characterize U.S. academic engagement in GNS over the past decade, with emphasis on geographic focus, thematic and subspecialty trends, and institutional leadership.
Methods:
PubMed, Embase, and Scopus were searched for studies published between 2014 and 2025. Eligible publications included original research, case reports or series, reviews, technical or programmatic studies, and commentaries involving neurosurgical populations in World Bank-classified low- and lower-middle-income countries (LIC/LMIC) and at least one U.S.-affiliated author. Extracted data included publication type, country of focus, U.S. academic institution, neurosurgical subspecialty, and thematic domain. Descriptive statistics, chi-square tests, and linear regression analyses were performed.
Results:
A total of 340 publications met inclusion criteria. U.S.-affiliated GNS output increased over time, with a mean annual increase of 5.9 publications. Collaborations involved 68 of 81 (81%) LIC/LMICs; however, research activity was unevenly distributed, as 57% of represented countries appeared in fewer than five publications. Sub-Saharan Africa accounted for 61% of country-specific publication instances. Most studies addressed general GNS topics (69%), while 31% focused on subspecialties. Education, training, and workforce development comprised 24% of publications. Among subspecialties, pediatric neurosurgery (36%) and trauma/traumatic brain injury (23%) predominated. Three journals accounted for 53% of publications, and three U.S. institutions contributed 37% of total output.
Conclusions:
Engagement in global neurosurgery has increased over the past decade but remains concentrated within a limited number of countries, subspecialties, journals, and institutions. These findings highlight opportunities to expand partnerships, and promote more equitable and inclusive neurosurgical scholarship.
