Clinical and Functional Outcomes of Thoracolumbar and Lumbosacral Spine Surgeries (Decompression, Laminectomy, and Fixation) in Neglected Cases of Trauma, Infection, and Listhesis in a Rural Population

Background: Thoracolumbar and lumbosacral spine disorders are a major cause of morbidity, particularly in rural populations where delayed presentation of trauma, infection, and degenerative conditions is common. Neglected cases often present with neurological deficits and spinal instability, posing significant challenges in management.

Aim: To evaluate the clinical and functional outcomes of thoracolumbar and lumbosacral spine surgeries, including decompression, laminectomy, and fixation, in neglected cases of trauma, infection, and listhesis in a rural population.

Methods: A prospective observational study was conducted in the Department of Orthopaedics at Kalpnath Rai Institute of Medical Sciences, Mau, Uttar Pradesh, from February 2025 to January 2026. A total of 50 patients with thoracolumbar and lumbosacral spine pathologies were included. Detailed clinical, neurological, and radiological assessments were performed. All patients underwent appropriate surgical intervention based on pathology. Outcomes were evaluated in terms of neurological improvement, functional recovery, radiological alignment, and postoperative complications. Data were analyzed using descriptive and inferential statistical methods.

Results: The majority of patients were aged 46–60 years (36%), with male predominance (64%) and rural residence (78%). Trauma was the most common etiology (44%), followed by infection (32%) and listhesis (24%). Thoracolumbar involvement was seen in 62% of cases. Neurological improvement was observed in 68% of patients postoperatively, while 24% showed no change and 8% worsened. Functional outcomes were good in 52%, fair in 32%, and poor in 16% of patients. Radiological alignment was maintained in 76% of cases. Postoperative complications were seen in 22% of patients, with infection being the most common (10%). Statistically significant associations were observed between functional outcome and factors such as age, etiology, neurological status, duration of presentation, comorbidities, and postoperative complications (p < 0.05).

Conclusion: Surgical management of thoracolumbar and lumbosacral spine pathologies provides satisfactory neurological and functional outcomes even in neglected cases. Early diagnosis, timely intervention, and improved healthcare accessibility are essential to enhance outcomes, particularly in rural populations.