Global Research Trends in the Surgical Management of Spasticity: A Systematic Review and Bibliometric Analysis

Surgical interventions remain a cornerstone in the multidisciplinary management of spasticity. While historically centered on pediatric cerebral palsy, the field has expanded with emerging techniques and shifting epidemiological patterns. Despite this evolution, no bibliometric study has analyzed the scientific landscape of surgical spasticity treatment. This study provides a comprehensive bibliometric analysis of global research trends, identifying historical milestones, emerging techniques, and leading institutions.

A systematic search of the Scopus database was conducted using a tailored query to retrieve English-language articles on surgical interventions for spasticity. Data were analyzed using bibliometric software to assess publication trends, citation metrics, keyword evolution, and network relationships among authors, institutions, and countries.

A total of 1,049 articles published between 1980 and 2024 were included. The most cited works focused on intrathecal baclofen therapy and selective dorsal rhizotomy. Recent years show growing interest in peripheral procedures such as selective neurotomies and nerve transfers, while central techniques such as DREZotomy and deep brain stimulation display declining trends. Although most publications target pediatric populations, studies involving adult patients are increasing, reflecting the rise of acquired spasticity. Most articles were published in high-impact journals, yet randomized controlled trials remain scarce.

This study highlights a progressive shift toward more tailored, peripheral, and neuromodulatory approaches, particularly in adult care. Future research should prioritize comparative trials and the integration of combined neuro-orthopedic strategies, supported by international collaboration and methodological standardization.