Case history: We present a case of spinal tuberculosis in a 4-year-old girl that grounds severe vertebral destruction involving four cervical vertebrae and a large abscess with retropharyngeal expansion. Presenting symptoms were neck and right arm pain, torticollis and weakness of the right arm. We drained the abscess and removed the infected bone and reconstructed the cervical spine with a fibular allograft. The neurological deficits were recovered and the torticollis was straightened up. Conclusion: We emphasize the value of early diagnosis of spinal tuberculosis and early radical surgery with spinal reconstruction.