Functional Recovery After Delayed Rehabilitation Following Surgically Managed Spinal Tuberculosis in an Adolescent: A Case Report

Spinal tuberculosis can cause vertebral destruction, neurological impairment, prolonged immobility and major loss of independence. We describe a 15-year-old male whose retained case documentation reported spinal tuberculosis involving the L2-L3 vertebral levels, followed by spinal surgery with internal fixation. Early rehabilitation was delayed and a short initial course of physiotherapy was discontinued. Approximately one year later, he presented to a specialist rehabilitation service with pain, restricted joint motion, marked lower-limb weakness, impaired bed mobility, poor balance and inability to walk independently. He then completed a progressive physiotherapy programme approximately four times weekly for about one year. Management advanced from symptom control, stretching, isometric exercise, bed-mobility practice and supported standing to isotonic strengthening, postural control, balance and coordination training, stepping and gait re-education. Lower-limb manual muscle testing improved from grade 2/5 to 5/5 at the hips and knees and from 3/5 to 5/5 at the ankles. Selected recorded functional items also showed marked improvement in self-care, transfers and locomotion. At later follow-up, the patient reported independent daily activities and no perceived residual disability. Because original imaging, operative, medication and standardized neurological records could not be retrieved, the exact neurological classification and contribution of each treatment component cannot be established. This case illustrates the potential for substantial functional recovery despite delayed rehabilitation and the importance of prospective standardized documentation.