Spinal tuberculosis (TB) is a rare form of extrapulmonary TB that can be clinically difficult to diagnose, particularly in pregnancy. This 24-year-old G2, P0 patient was diagnosed at 19 weeks gestation, 2 days after a protracted admission for hyperemesis gravidarum, COVID-19 infection, and unexplained transaminitis with bilateral lower limb weakness and urinary retention. She underwent emergent spinal decompression surgery with expectant management on intravenous antitubercular medication and cesarean delivery at 34 weeks gestation. Spinal tuberculosis is a difficult diagnosis, impacted by medical comorbidities, pregnancy, and diagnostic bias. This case describes successful antenatal management of spinal tuberculosis and highlights the importance of interdisciplinary care.
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