Abstract
Spinal tuberculosis (TB), also known as Pott's spine, remains a significant cause
of spinal deformity and neurological compromise, particularly in endemic regions.
Surgical correction of chronic deformities is associated with significant risks, including
spinal cord injury. Intraoperative neurophysiological monitoring (IONM) has become
an essential tool to minimize neurological complications. We report a case of an adolescent
boy with longstanding thoracolumbar kyphosis due to spinal TB, where IONM identified
true positive motor pathway compromise during deformity correction, despite intraoperative
C-arm imaging confirming correct pedicle screw placement. Surgery was halted, and
staged completion was planned. Postoperative neurological deficits confirmed the predictive
validity of IONM. This case highlights the indispensable role of IONM in surgical
decision-making, particularly in complex TB-related deformities where imaging alone
may be insufficient to prevent neurological injury.
Keywords
Pott's spine - spinal tuberculosis - intraoperative neuromonitoring - kyphotic deformity
- spinal cord injury
