Thoracic Spinal Tuberculosis in Late Pregnancy: Corpectomy and Instrumented Fusion Ensuring Maternal and Fetal Safety

Spinal tuberculosis (TB) is a rare but serious form of extrapulmonary TB that can cause spinal deformity and neurological deficits. Its occurrence during pregnancy is uncommon, presenting diagnostic and therapeutic challenges due to the dual imperative of maternal neurological preservation and fetal safety. We report the case of a 25-year-old woman at 30 weeks of gestation who presented with progressive midback pain, weight loss, and rapidly worsening spastic paraplegia. Magnetic resonance imaging revealed extensive thoracic spinal TB with vertebral destruction and spinal cord compression. She underwent D5–D7 corpectomy and instrumented fusion. Postoperative antitubercular therapy led to complete neurological recovery and a healthy full-term infant, highlighting safe multidisciplinary management in pregnancy. Timely recognition and carefully planned surgical intervention, combined with appropriate antitubercular therapy, can result in excellent neurological recovery and favourable maternal and fetal outcomes in complicated spinal TB during pregnancy. Multidisciplinary management is essential to balance maternal safety and fetal well-being.