Beyond Kyphosis: A Case of Tuberculous Spondylodiscitis With L3 Vertebral Dislocation

Spinal tuberculosis (TB) accounts for the majority of skeletal TB cases and remains a significant cause of morbidity in developing nations. While thoracic involvement is most common, lumbar vertebral dislocation represents an exceedingly rare and severe complication. This case involved a 22-year-old female who presented with a six-month history of severe back pain followed by the sudden onset of complete paraplegia with bowel and bladder incontinence. Despite initiation of antitubercular therapy (ATT) at another facility, her condition progressively worsened. Neurological examination revealed flaccid paralysis of both lower limbs and complete sensory loss below the L3 level. Imaging confirmed L3 vertebral body destruction with anterior dislocation consistent with tuberculous spondylitis and spinal instability. Surgical intervention was performed via an anterior retroperitoneal approach, including L3 corpectomy, debridement of infected tissue, and anterior column reconstruction using an autologous iliac crest bone graft. This case illustrates a rare presentation of tuberculous spondylodiscitis with vertebral dislocation and highlights the importance of early diagnosis and timely surgical intervention in patients with progressive neurological deficits and spinal instability. While ATT remains the cornerstone of treatment, surgical decompression and stabilization are imperative in cases of significant mechanical instability to prevent further neurological deterioration.