A 28-year-old pregnant woman with spinal tuberculosis and progressive neurological deterioration underwent complex spinal surgery at 28 weeks of gestation at Meenakshi Super Specialty Hospital, Madurai. Despite the surgical and obstetric challenges, she subsequently completed her pregnancy and delivered a healthy baby. The patient had experienced neck pain for almost a year before developing progressive sensory impairment, difficulty walking, and loss of sensation below the chest.

MRI findings raised suspicion of spinal tuberculosis, while worsening neurological deficits and spinal instability prompted the surgical team to intervene during pregnancy rather than wait for further deterioration. The procedure involved a T1-T2 decompressive laminectomy to address spinal cord compression, along with removal of infected tissue and biopsy. This was followed by extensive C3-T4 spinal fusion…