A total of 336 articles that met our search criteria were retrieved from the Web of Science database. The volume of articles published in the field of surgical treatment of CTS research by country and region worldwide was analyzed (Figure 1A). The USA contributed the most articles in this area (114, 34.03%), followed by the UK (25, 7.46%), Japan (21, 6.27%), the Netherlands (21, 6.27%), and China (18, 5.37%). The data was used in CiteSpace software for visual analysis.

A search within the Web of Science database by subject term revealed a total of 336 articles included in it, along with a count of the number of articles published in each 1-year period (Figure 1B).

The study found a steady upward trend in the number of publications from 2003 to 2022, with the highest number of publications (27) in 2020 and a plateau in the last 3 years. The trend in publications suggests that the surgical treatment of CTS has been gaining increasing attention from researchers over the last 20 years. It can be predicted that the annual number of publications in this field will continue to trend upwards.

The trend extrapolation trend analysis using SPSS software predicts future publishing trends in the field (Figure 1C). Indicates an upward trend in the number of publications in the future.

Dividing all articles by category (Figure 1D), the highest of these 336 articles was Article (302, 89.88%), followed by Review Article (34, 10.12%), and Proceeding Paper (5, 1.5%).

In the Web of Science database, the study covered 32 fields (Figure 1E), with the majority of the literature concentrated on “Surgery” (157; 46.73%), “Orthopedics” (135; 40.18%), “General Internal Medicine” (52; 15.48%) and “Neurosciences Neurology” (44; 13.10%), (135; 40.18%), “General Internal Medicine” (52; 15.48%) and “Neurosciences Neurology” (44; 13.10%), indicating that the Surgical treatment of CTS is a multifaceted and multidisciplinary field that covers a wide range of societal benefits.

All 336 articles were published in 38 journals. The top 10 journals in terms of publication volume are shown in Table 1, among which JCR Q1 4, Q2 1, Q3 3, Q4 2, and the overall publication quality is high.

The national collaboration networks from 2003 to 2022 were visualized through CiteSpace software and mapped (Figure 2A), showing countries that published at least 10 articles. The country with the highest number of publications is the USA with 114 articles, accounting for 33.93% of total publications, and maintains collaborative relationships with 17 other countries, with the top 5 also including the UK (25 articles), Japan (21 articles), the Netherlands (21 articles), and China (19 articles). China is the only developing country among them.

Higher centrality values, also known as mediated centrality, indicate the more active and closer role that nodes play in collaborative relationships with other nodes, and individuals with high centrality are marked with a purple halo in the graph. The USA (0.66) has a high intermediary centrality (Figure 3), indicating that it plays an important bridging role in the network of countries cooperating in this area. Japan (0.00) and China (0.01) do not have high centrality, although they have a higher number of publications.

With all 336 articles originating from 316 researchers, we generated an author collaboration network for this research study (Figure 2B). In the author collaboration network, each node represents an author, the line between the nodes represents a collaborative relationship between two individuals, and the color of the line represents the year of collaboration. As shown in the figure, there is less collaboration between researchers and between teams of researchers in this research area. At the same time, some scholars have formed collaborative networks centered on themselves and have a more consistent article output (Figure 2C). Overall, there is a lack of collaboration between many scholars and teams, with some important teams with a large number of early publications even phasing out of the field.

The names and number of publications in the last 10 years involving surgical treatment of CTS are shown in Table 1, with JOURNAL OF HAND SURGEGY AMERICAN VOLUME being the most productive journal with 47 articles, followed by PLASTIC AND RECONSTRUCTIVE SURGERY with 13 articles, both of which are specialist journals in the neighborhood of the specialty. We also used CiteSpace to generate a citation co-occurrence graph for journals (Figure 2B). The nodes in the graph represent journals, and the connections between the nodes represent citation relationships. In addition, the purple ring outside the node represents the centrality of the journal, and nodes with high centrality are considered to be key journals. The top ranked journals for frequency and centrality are JOURNAL OF HAND SURGEGY AMERICAN VOLUME and JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY, respectively. Of all the citations in JOURNAL OF HAND SURGERY AMERICAN VOLUME, one of the articles that has received more attention is a questionnaire analysis of members of the American Society for Surgery and Hand Surgery, in which the authors investigate the location of the procedure, the use of preoperative electrophysiological aids to diagnosis, the use of preoperative antibiotics, the choice of surgical incision, the choice of anesthesia, and the management of the patient postoperatively. The questionnaire survey is, in our opinion, of interest to researchers worldwide studying the surgical treatment of CTS.

Keyword co-occurrence plots (Figure 4A) were obtained from keyword analysis in the literature using CiteSpace software. Modularity Q = 0.7602, with modularity 0.4–0.8 usually forming n small natural network clusters that satisfy the analysis requirements. Weighted mean silhouette S = 0.7579, when S ≥ 0.5, clustering is generally considered more S = 0.7579, when S ≥ 0.5, the clustering is generally considered more reasonable and meets the analysis requirements. Each node represents a keyword, the size of the node represents the frequency of the keyword, the linkage of two nodes represents the co-occurrence of two keywords, the color of the linkage represents the time, and the thickness represents the degree. Based on frequency and centrality, we found the following popular keywords: carpal tunnel syndrome, surgery, release, median nerve, diagnosis, questionnaire, decompression, complication, prevalence carpal tunnel release, diagnosis, risk factor, breast cancer, carpal tunnel, complication, decompression, and release (Table 2). It can be seen that the main focus of research on surgical treatment of CTS is on the release of carpal tunnel, changes in median nerve function, prognosis and the mechanism of CTS development.

The keywords were analyzed by clustering (Figure 4B) and the keywords were clustered into 12 LABELS with the clustering labels derived from the LSI/LLR/MI algorithm and the number of clusters was inversely proportional to the size of the clusters. These clustered keywords can reflect the research hotspots in surgical treatment of CTS which can guide the development pattern of this research and new directions of research.

The keyword timeline analysis of the literature was obtained using CiteSpace software to obtain the keyword timeline mapping (Figure 4C). The analysis showed that the pre-research direction mainly focused on research related to the pathogenesis of CTS, with keywords around CTS, surgery, release, median nerve, and diagnosis, which we believe is since after the third technological revolution, especially since 2000, human production and lifestyle have The significant increase in the incidence of soft tissue disorders of the neck and upper limbs (15) following the third technological revolution has led to an increased interest in CTS among surgeons. Since 2005, the field of endoscopic surgery for CTS has evolved, although endoscopic surgery for CTS was reported by Okutsu as early as 1987 (16). A gee and Chow reported on two commonly used endoscopic techniques, the single-channel technique (17) and the dual-channel technique (18). In the last decade, researchers have continued to explore the best treatment modalities for moderate-to-severe CTS, including the use of a single-channel technique and a dual-channel technique. In the last decade, researchers have continued to explore the best treatment modalities for moderate to severe CTS, including drug injection therapy, individualized treatment, and the exploration of risk factors (Table 3).

The keyword bursts in the literature were analyzed using CiteSpace software to obtain the 10 keywords with the highest number of citation bursts (Figure 4D). The analysis showed that the keywords decompression (3.22), conduction (2.8), prevalence (4.62), management (2.91), and hand (2.75) had a long duration, and prevalence (4.62), cubital tunnel syndrome (3.38), and decompression (3.22) had high burst intensities indicating that these keywords were research hotspots in the corresponding periods. Prevalence (4.62), pain (3.45), management (2.91), and ulnar nerve entrapment (2.44) continued their prominence in the past 5 years to date, and all have been hotspots of research in recent years.