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Boro finished with just nine men after a pulsating encounter at the Riverside.
Both Ben Gibson and Kenneth Omeruo were sent off for second yellow cards in a frantic second half of a lively clash that was also marked by two cracking first half goals and both sides forced into substitutions for injuries before the break.
Boro weathered a storm then went ahead as Danny Graham stabbed home after a corner then made it two as Jacob Butterfield curled in a cracker – although City matched that with a 30 yard rocket from Emyr Huws.
Boro missed a string of chances to seal it before they were rocked by quick-fire dismissal but then dug deep and sealed it late through Lee Tomlin.
View gallery Boro v Birmingham match action
View gallery Boro made just one change with Jacob Butterfield replacing Lee Tomlin in the middle of the attacking midfield three. On the bench Jonathan Woodgate returned after five weeks out with a calf injury.
Boro had a lucky escape in only the second minute as Novak raced behind a flat-footed defence onto a cross to slot past Konstantopoulos but the offside flag was already up.
Boro's first chance came on five minutes as Jacob Butterfield picked out Nathaniel Chalobah just outside the box to send in a dipping shot that keeper Randolph did well to tip over for a corner.
Then when Grant Leadbitter whipped the flag-kick in Ben Gibson powered in a header that was nodded off the line by Novak.
On 10 minutes George Friend made a superb sliding tackle on Burke in the box then set off surging up the flank only to pull up suddenly and limping off for treatment.
On 15 minutes Boro won a free-kick after lively Chalobah was hauled back. When Leadbitter's effort canonned into the wall Butterfield played the rebound into the crowd for Chalobah to head just wide from 10 yards out.
On 20 minutes Friend limped off after another crunching tackle and sprint saw him limping again. Jonathan Woodgate came on with Leadbitter handing the defender the armband.
Birmingham threatened on 23 minutes as a Burke corner was half-cleared and when Shinnie's shot was blocked and Spector back-heeled the loose ball across the face of goal and it bobbled towards the far post where it was hacked clear.
And Birmingham should have scored on 25 minutes as a slotted Novak pass sent unmark Burke darting behind the defence to draw out keeper Dimi Konstantopoulos but when he chipped goalwards Kenneth Omeruo somehow appeared on the line to head it over.
But Boro hit back to take the lead on 28 minutes as Woodgate nodded down a Leadbitter corner from the right and DANNY GRAHAM controlled deftly then stabbed home on the turn from six yards out.
And Boro scored a second two minutes later as alert Jozsef Varga took a quick throw towards JACOB BUTTERFIELD on the corner of the box and he turned neatly onto it then curled over the keeper and into the far top corner.
And they had a chance for a third on 35 minutes when the keeper palmed down a Butterfield shot then rushed his clearance which fell to Graham 35 yards out and he tried a first time effort that sent rattled Randolph diving to save.
But Birmingham were back in it out of the blue on 36 minutes as EMYR HUGHES picked up a loose ball wide on the right then cut inside to unleash a sizzling angled 30 yard shot that flew past the diving keeper and inside the far post.
And the visitors threatened again on 42 minutes as Burke cut in from the right and got a lucky deflection off Gibson then squared towards Macheda but Leadbitter had tracked back and cut out the danger and cleared.
On 45 minutes Omerou was booked for a foul on Caddis.
On the stroke of half-time City almost snatched a leveller as full-back Reilly got down the left and crossed for Shinnie to ghost through and head just wide.
In stoppage time City striker Novak went down injured and was stretchered off with a Zigic coming on in his place.
HALF-TIME: BORO 2 BIRMINGHAM C 1
After a low key start to the second half Boro almost broke out to score a third on 51 minutes as Butterfield played a neat ball behind the defence to send Graham through one-on-one with the advancing keeper but as he tried to chip Randolph just got a touch to send it looping on the roof of the net.
That sparked a decent spell as Chalobah sent a low shot that was deflected behind for a corner which led to a scramble and then Adomah sent a shot flashing well wide.
On 55 minutes Reilly was booked for bringing down Adomah as he set off on a run down the right.
Then from the free-kick Butterfield anticipated the flick on by Chalobah to lash a first time effort just over.
And Boro threatened on the hour as Gibson played forward for Butterfield to touch on and send Graham storming through into the box but a poor touch sent him too wide then when Adomah recovered theball and squared, Luke Williams fired a 25 yard curling effort into the arms of the keeper.
Two minutes later another deft touch from Butterfield sent Graham bursting into the box again and when he tried to steer it around the right of the advancing Randolph the keeper guessed right and dived to block it.
On 63 minutes Robinson was booked for a foul on Adomah.
That led to a free-kick wide on the right that Leadbitter played short for Williams to turn just over.
On 66 minutes City put on Ibe for Shinnie and a minute later Boro put on Emmanuel Ledesma for Williams.
Boro were back on the attack on 71 minutes as Ledesma cut in from the right and sent an angled 25 yard effort zipping towards the far post forcing a full length save.
And a minute late they went close again as a Butterfield ball into the box that deflected into the path of Ledesma and he poked it down and it bounced up forcing the keeper to tip over.
Then from the corner a powerful Woodgate effort was blocked at the near post then his follow up header was blocked and scrambled away.
On 77 minutes Boro put on Lee Tomlin for Butterfield.
The substitute almost scored within two minutes of coming on as he drilled in an angled 15 yard shot that came back off the post, hit the keeper and bounced out.
Boro had Omeruo sent off for a second yellow card on 80 minutes in a flare-up. Ledesma was fouled as City broke forward and first Gibson tried to haul down Zigic as he broke forward – and was booked – then Omeruo bodychecked him.
City put Adeyemi for Spector on 83 minutes.
Boro were down to nine men on 86 minutes as City streamed forward and Gibson pulled back Zigic to earn a second yellow card.
But as City threw men forward looking to take advantage Boro broke out to seal victory with a third.
Adomah knocked the ball forward and LEE TOMLIN burst to the edge of the box and as two defenders hampered each other he slammed in a low ball that came back off the keeper and the sub then cracked in the rebound.
He was then booked for over celebrating.
The nine men had to dig deep in a frantic closing spell but they battled bravely with the crowd roaring them on.
BORO (4231): Konstantopoulos, Varga, Omeruo, Gibson (Woodgate 20), Friend, Leadbitter (C), Chalobah, Williams (Ledesma 67), Butterfield (Tomlin 77), Adomah,Graham. Subs: Steele, Atkinson, Main, Kitching.
BIRMINGHAM (442): Randolph, Robinson ©, Thorpe, Reilly, Spector (Adeyemi 84), Novak (Zigic 45+3), Shinnie (ibe, 66), Caddis, Huws, Burke, Macheda. Subs: Doyle, Packwood, Lee, Furguson.
Ref: Carl Boyeson (Hull)
Att:13,399 (334)
