Surgical Management of Post-tuberculous Spinal Deformity in Adults: A Case Series Report from a Nigerian Tertiary Orthopaedic Centre

Abstract

Post-tuberculous spinal deformity remains an important cause of chronic morbidity following healed spinal tuberculosis, particularly in low- and middle-income countries. Residual kyphosis may result in persistent pain, sagittal imbalance, cosmetic deformity and late neurological deterioration. Surgical correction is technically demanding because of rigid deformity and compromised bone quality, yet it may offer meaningful functional recovery when appropriately indicated. We report a case series of three adult patients with post-tuberculous spinal deformity managed surgically at a Nigerian tertiary orthopaedic centre. All patients underwent single-stage posterior-only decompression, deformity correction and pedicle screw–rod instrumentation. Anterior column reconstruction was performed in all cases using either an expandable titanium cage or a fibular strut graft. Clinical, radiological and neurological outcomes were assessed during follow-up. The patients were aged 24–33 years (median 32 years), with follow-up ranging from 26 to 60 months (median 36 months). Two patients presented with thoracic kyphotic deformity (90° and 92°), while one had lumbar involvement (20°). Postoperatively, thoracic kyphosis improved to 25° and 45°, and lumbar alignment was restored to physiological lordosis. The median angular correction achieved was 47° (range 40°–65°). One patient presented with paraparesis (ASIA D) and achieved complete neurological recovery, while the remaining two maintained intact neurology (ASIA E). All patients demonstrated radiological fusion and maintained deformity correction at the latest follow-up, with no implant-related complications. Single-stage posterior-only surgical correction of post-tuberculous spinal deformity in adults can achieve satisfactory deformity correction, solid fusion and neurological recovery in carefully selected patients.