Tubercular paraplegia in pregnancy with complete neurological recovery following antitubercular therapy: a case report
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20263066Keywords:
Pott's spine, Spinal tuberculosis, Pregnancy, Paraplegia, Antitubercular therapy, Cord compressionAbstract
Spinal tuberculosis with paraplegia during pregnancy is rare and is a diagnostic and therapeutic challenge. Pregnancy, being a relatively immunocompromised state, may prompt rapid destruction of the vertebral body, resulting in an acute and profound neurological deficit. A 23-year-old G2P1L1 woman at 19+5 weeks presented with progressive bilateral lower-limb weakness; MRI showed D2 collapse with epidural collection and cord compression. Sputum Ziehl-Neelsen staining confirmed acid-fast bacilli, and first-line HRZE therapy was started. She recovered completely, continued pregnancy to term, and delivered a healthy male neonate by elective caesarean section. This case supports early MRI diagnosis and timely anti-tubercular therapy alone in selected patients with multidisciplinary care and close maternal-fetal monitoring can lead to complete recovery.
References
World Health Organization. Global tuberculosis report 2024. Geneva: World Health Organization; 2024.
Rajasekaran S, Soundararajan DCR, Shetty AP, Kanna RM. Spinal Tuberculosis: Current Concepts. Global Spine J. 2018;8(4 Suppl):96S-108S.
Dunn RN, Ben Husien M. Spinal tuberculosis: review of current management. Bone Joint J. 2018;100-B(4):425-31.
Hui SYA, Lao TT. Tuberculosis in pregnancy. Best Pract Res Clin Obstet Gynaecol. 2022;85(Pt A):34-44.
Sobhy S, Babiker Z, Zamora J, Khan KS, Kunst H. Maternal and perinatal mortality and morbidity associated with tuberculosis during pregnancy and the postpartum period: a systematic review and meta-analysis. BJOG. 2017;124(5):727-33.
Govender S, Moodley SC, Grootboom MJ. Tuberculous paraplegia during pregnancy. A report of 4 cases. S Afr Med J. 1989;75(4):190-92.
Kaushal S, Dora SK, Thakur S. Spinal Tuberculosis with Paraplegia in Pregnancy. J Nepal Med Assoc. 2015;53(198):123-5.
Srivastava S, Raj A, Agarwal R, Bhosale S, Marathe N. Management dilemma of tuberculous paraplegia in pregnancy: a case report and review of literature. Surg Neurol Int. 2020;11:470.
Chandrasekaran S, Krishnamurthy KA, Kalimuthu B. Spinal tuberculosis in pregnancy: a case series. J Clin Diagn Res. 2024;18(2): RR01-RR03.
Yadav A, Singh A, Aggarwal K. A case of acute-onset paraplegia due to spinal tuberculosis in term pregnancy. Obstet Med. 2023;16(4):242-4.
Mahdoom BWMA, Karunasingha J, Meegoda VJ, Packianthan JD. A conservative management approach for spinal tuberculosis causing cauda equina syndrome in pregnancy. Sri Lanka J Obstet Gynaecol. 2024;46(3):79-82.
Shaikh H, Chouhan A. Surgical Management of Pott's Paraplegia in a 27-Week Pregnant Woman with Continuation of Pregnancy: A Case Report. J Orthop Case Rep. 2026;16(5):48-53.
World Health Organization. WHO TB Knowledge Sharing Platform: treatment of drug-susceptible tuberculosis. Geneva: World Health Organization.
Centers for Disease Control and Prevention. Tuberculosis clinical care and treatment during pregnancy. Atlanta (GA): CDC; 2025. Available at: https://www.cdc.gov/tb/hcp/clinical-care/pregnancy.html. Accessed on 3 June 2026.
Chakhtoura N, Rungruengthanakit K, Wiesner L, Capparelli EV, Stek AM, Mirochnick M, et al. Pharmacokinetics and safety of first-line tuberculosis drugs rifampin, isoniazid, ethambutol, and pyrazinamide during pregnancy and postpartum: results from IMPAACT P1026s. Antimicrob Agents Chemother. 2023;67(11):e0073723.
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