Leadership and inequality in latin american neurosurgery, 2000–2024: a bibliometric and geospatial study
摘要
Latin America has experienced rapid neurosurgical growth over the past two decades, yet its distribution and leadership dynamics remain poorly characterized.
MethodsA longitudinal bibliometric and network analysis was conducted on neurosurgical publications affiliated with Latin American institutions (2000–2024) using data from Scopus and PubMed. Records were harmonized with bibliometrix (R ≥ 4.2), fractionalized by country, normalized by population and GDP, and analyzed for inequality (Gini, Theil) and authorship leadership (first, last, corresponding).
ResultsA total of 1,580 publications were identified across 19 countries. Annual output increased more than 60-fold, from 4 papers in 2000 to 251 in 2024. Segmented regression revealed a structural breakpoint in 2014 (post-2015 slope = 1.63 ± 0.12; p < 0.001), marking accelerated growth. Four nations—Brazil, Mexico, Argentina, and Colombia—produced 76% of all output. Inequality remained high (Gini = 0.801; Theil = 1.382). International co-authorship occurred in 31.2% of papers. In the whitelist-restricted primary dataset, Latin American first authorship was common (58.7%), whereas last-author signals were sparse in structured metadata (3.4%). In a prespecified position-matched sensitivity analysis, Latin American last authorship was common in domestic-only papers but fell to 10.0% in internationally co-authored papers. The collaboration network centered on Brazil, Mexico, and Chile, with limited connectivity elsewhere.
ConclusionsLatin American neurosurgical research is expanding rapidly but remains highly concentrated. Bridging structural inequities through decentralized funding, equitable authorship frameworks, and open, regionally governed networks is essential to convert output growth into sustainable scientific leadership.