Tuberculosis (TB) remains a major global health issue, particularly in low-resource settings, where it significantly contributes to maternal morbidity and mortality. While pulmonary TB is more common, extrapulmonary TB, including spinal involvement, presents unique diagnostic and management challenges during pregnancy. We report a rare case of spinal TB in a 23-year-old primigravida at 22 weeks gestation who presented with progressive lower limb weakness and sensory loss. MRI revealed thoracic vertebral involvement with spinal cord compression. Following thorough evaluation by a multidisciplinary team, the patient underwent a D7–D10 laminectomy and decompression under general anesthesia with fetal and maternal safety precautions. Postoperatively, she was started on antitubercular therapy. Neurological recovery was rapid, and fetal wellbeing was maintained throughout the hospital course. This case highlights the importance of early diagnosis and a coordinated multidisciplinary approach in managing complex TB presentations in pregnancy, enabling favorable maternal and fetal outcomes.
Rastogi et al. (2026) studied this question.