Spine Clinic in Noida

Late Neurological Deterioration—Tubercular Kyphosis: The Role of Internal Gibbectomy Severe post-tubercular kyphosis can occasionally cause neurological deterioration many years after the active infection has healed. A prominent internal gibbus can compress an already stretched and compromised thoracic spinal cord, producing progressive myelopathy and difficulty walking. A recent case illustrates this problem. A 40-year-old man had been treated for MDR spinal TB involving D6–D7 seven years earlier. He underwent left-sided costotransversectomy without fixation at another center. Although the infection was drained, the angular deformity remained. Following a stormy postoperative course with paraplegia, sepsis, pneumothorax, AKI, and ventilatory support, he gradually recovered. With prolonged ATT and rehabilitation, his neurological function improved sufficiently for him to walk with a stick and return to work. For several years he remained stable. However, six months ago, he again developed progressive imbalance, heaviness of the legs, and difficulty walking. CT and MRI demonstrated a severe angular kyphosis with an internal gibbus causing thoracic spinal cord compression at D6–D7. Importantly, the anterior column was already solidly fused. Choosing Decompression Over Aggressive Correction Modern spine surgery allows major deformity correction using advanced posterior instrumentation and vertebral column resection techniques.