Spinal tuberculosis accounts for up to 50% of all cases with musculoskeletal tuberculosis. In patients needing surgical treatment, the use of anterior instrumentation offers the theoretical advantage of more complete debridement and decompression, safer mobilization and reliable deformity correction. However, the placement of instrumentation in an infected area remains a matter of debate. We present a patient with thoracic vertebral tuberculosis using an antibiotic crescent-shaped PMMA strut for spinal reconstruction and fusion. The patient recovered satisfactory and no complication was observed in the follow-up. The antibiotic crescent-shaped PMMA strut can be used as a carrier for antibiotic drug and an ideal alternative for anterior spinal reconstruction. However, long-term outcome in this case requires further evaluation.