Reconstruction of complicated spinal tuberculosis with long-segment fibula transplantation: a case report

This case report discusses the treatment of a 60-year-old woman with spinal tuberculosis affecting multiple vertebrae, leading to paralysis. The treatment involved surgical and drug-based interventions to address spinal cord compression and restore function. The patient underwent a two-stage surgical procedure including abscess clearance, spinal decompression, long-segment fixation, lesion debridement, and bilateral fibula graft support, combined with anti-tuberculosis drug therapy. The case highlights the importance of prompt spinal cord decompression and suggests that limited debridement with drug therapy can be safer than extensive surgery in certain complex cases of spinal tuberculosis.

• 1
  Emergency posterior paraspinal abscess clearance, laminectomy with spinal decompression, and long-segment fixation improved the patient's neurological status from grade B to grade E on the ASIA scale.
• 2
  Two-stage transabdominal anterior abscess removal, partial debridement, and bilateral fibula graft support, combined with anti-tuberculosis drug therapy, led to significant pain reduction and normalization of inflammatory markers.
• 3
  The unconventional long-segment fibula graft with pelvis-vertebral support proved to be an effective reconstruction method, with no fibula subsidence observed during the five-year follow-up.