Conceptual and geographical shifts in minimally invasive neurosurgery: a bibliometric perspective

The “keyhole approach” in minimally invasive neurosurgery (MINS) utilizes precise anatomical corridors to access intracranial targets with minimal collateral footprint. This study performs a bibliometric analysis to elucidate the field’s evolutionary trends, hotspot shifts, and research gaps over the past two decades.

Literature explicitly indexed under the keyhole concept from 2003 to 2025 was retrieved from the Web of Science Core Collection (WoSCC) using a focused topic search strategy. VOSviewer, CiteSpace, and Bibliometrix were utilized to visualize spatial-temporal networks, author influence, and thematic clusters.

A total of 590 articles exhibited a robust upward trajectory. The USA dominates in output and impact, while China ranks second, showing emerging stewardship through high corresponding authorships (e.g., Qing Lan). World Neurosurgery is the most prolific journal. Crucially, keyword evolution signifies a paradigm shift from a “vascular/eyebrow” era to an “oncological/endonasal” era. Thematic clustering confirms a “target-centric” maturation where surgical modalities are inextricably tethered to pathologies, distinguishing established supratentorial corridors from the nascent, isolated transorbital frontier.

Over the past 20 years, the keyhole concept has metamorphosed from an “access-centric” technique to a “target-centric” neuro-oncological pillar, driven by the fusion of endoscopy and neuronavigation. Future research must bridge the identified “bibliometric void” by prioritizing digital augmentation (robotics, AR) and functional validation to maximize patient quality of life.