Bridging the gap: Gardner-Wells tongs utilization in pediatric spinal tuberculosis: A case report

Spinal Tuberculosis (TB), or Pott's disease, is a significant form of extrapulmonary TB affecting the spine, especially in children. Standard treatments include anti-tuberculosis medications, immobilization, and surgery. The use of Gardner well tongs (GWT) in pediatrics spinal TB is rare due to associated risks and lack of supporting evidence. This case report aims to document the application of GWT traction in conjunction with surgical intervention for a pediatric patient with tuberculosis spondylitis. An 8-year-old boy presented with progressive weakness in both legs over 2.5 years, culminating in his inability to stand or walk. Physical examination revealed asymmetrical back, gibbus formation, tenderness, limited range of motion, and upper motor neuron neurological deficits. Radiographic imaging showed vertebral body destruction from T1–6, causing an 81-degree kyphotic curve. The patient underwent 5 kg of GWT traction for 2 weeks, resulting in a 10-degree improvement in curvature. Subsequent surgical procedures included laminectomy, posterior stabilization, deformity correction, and post-operative application of a SOMI brace. By discharge, the patient's kyphotic angle had improved from 81 to 63°, and there was notable improvement in motor strength and neurological function. While surgical intervention is often necessary for vertebral deformity restoration, GWT offers advantages in spinal TB management, such as achieving stable cervical segments without skin incision and aiding gradual kyphotic correction. Serious complications from GWT, like skull perforation or neurovascular damage, are infrequent. A comprehensive, holistic approach incorporating GWT traction and surgical intervention is essential for improving clinical outcomes in pediatric tuberculosis spondylitis. •Spinal Tuberculosis, is a form of extrapulmonary TB that affects the spine, particularly in pediatric populations.•Spinal TB treatment in pediatric patients focuses on anti-tuberculosis medication, immobilization, and surgical intervention.•The use of Gardner well tongs (GWT) is not commonly chosen for treatment due to its risk and lack of evidence.•Up to day, there is still no case report that reported the usage of GWT in pediatric patient with spinal tuberculosis.•This report aims to share our experience in using GWT traction with surgical intervention for managing pediatric spinal TB.