BACKGROUND: Spinal tuberculosis (STB), or Pott’s disease, is a relatively frequent form of extrapulmonary involvement representing 50% of bone tuberculosis. Its diagnosis continues to be challenging due to the insidious presentation of the condition and is essential because it can cause disability due to late diagnosis or inadequate management.

CASE REPORT: The objective of this study is to report a case of Pott’s disease due to multidrug-resistant bacilli in a pediatric patient who required surgical management with pharmacological support in a tertiary care pediatric hospital. The management of these deformities is surgical; however, with new technologies and techniques in spinal surgery, the best approach for this type of patient has been discussed, whether it should be anterior, posterior, or mixed. In our case, a 360° approach was necessary due to the magnitude of the deformity with a favorable postoperative period with good tolerance to antituberculosis drugs without additional neurological deficit.

CONCLUSIONS: Pott’s disease due to multidrug-resistant bacilli continues to be a challenge thanks to the insidious presentation of the condition. However, there is no consensus regarding the best surgical approach for patients with the presented characteristics.