{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T10:33:52Z","timestamp":1773398032518,"version":"3.50.1"},"reference-count":12,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec id=\"st1\">\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Conjoined twins are univitelline, monochorionic, and monoamniotic, with imperfect division. The estimated worldwide prevalence is 1.47\/100,000 births, with approximately 50% resulting in live births. They are classified according to the most prominent site of fusion. Pygopagus twins are joined at the sacral region and are the third most common variation, representing 6\u201319% of conjoined twins. Pygopagus twins may have a fused spinal canal and spinal cord, presenting a neurosurgical challenge during separation surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"st2\">\n                    <jats:title>Case Description:<\/jats:title>\n                    <jats:p>We report the case of conjoined twins diagnosed prenatally by ultrasound, who, on radiological investigation after birth, were identified as pygopagus twins with fusion of the lumbosacral vertebral canal and a \u201cU\u201d-shaped spinal union. They underwent successful separation surgery using neuromonitoring.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"st3\">\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Pygopagus twins with a fused spinal canal and spinal cord are a neurosurgical challenge during separation surgery. It is a rare condition; therefore, meticulous planning is essential for a good prognosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.25259\/sni_41_2025","type":"journal-article","created":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T09:02:34Z","timestamp":1773392554000},"page":"135","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pygopagus conjoined twins: A case report and neurosurgical nuances in separation surgery"],"prefix":"10.25259","volume":"17","author":[{"given":"Rafael Harter","family":"Tomaszeski","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luiza","family":"Ribeiro","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lilian Carine Souza de Lima","family":"Abdon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gerson Evandro","family":"Perondi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samir Cezimbra","family":"Dos Santos","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2026,3,13]]},"reference":[{"key":"10.25259\/SNI_41_2025\/ref-1","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1007\/BF00171789","article-title":"Separation of pygopagus twins","volume":"1","author":"Chatterjee","year":"1986","journal-title":"Pediatr Surg Int"},{"key":"10.25259\/SNI_41_2025\/ref-2","doi-asserted-by":"crossref","first-page":"554","DOI":"10.1016\/S0022-3468(79)80138-4","article-title":"The surgical separation of pygopagous twins","volume":"14","author":"Cloutier","year":"1979","journal-title":"J Pediatr Surg"},{"key":"10.25259\/SNI_41_2025\/ref-3","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1016\/j.jpurol.2005.01.015","article-title":"The use of a three-dimensional imaging model to optimize the operative separation of pygopagus conjoined twins","volume":"1","author":"Cook","year":"2005","journal-title":"J Pediatr Urol"},{"key":"10.25259\/SNI_41_2025\/ref-4","doi-asserted-by":"crossref","first-page":"e5","DOI":"10.1097\/WNP.0000000000000343","article-title":"Pygopagus conjoined twins: A neurophysiologic intraoperative monitoring schema","volume":"34","author":"Cromeens","year":"2017","journal-title":"J Clin Neurophysiol"},{"key":"10.25259\/SNI_41_2025\/ref-5","doi-asserted-by":"crossref","first-page":"402","DOI":"10.1055\/s-0029-1202855","article-title":"Surgical separation of a rare case of male pygopagus","volume":"19","author":"El Gohary","year":"2009","journal-title":"Eur J Pediatr Surg"},{"key":"10.25259\/SNI_41_2025\/ref-6","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1097\/ACO.0000000000000864","article-title":"Conjoined twins in 2020-state of the art and future directions","volume":"33","author":"Frawley","year":"2020","journal-title":"Curr Opin Anaesthesiol"},{"key":"10.25259\/SNI_41_2025\/ref-7","doi-asserted-by":"crossref","first-page":"699","DOI":"10.1007\/s00381-012-2007-2","article-title":"Separation surgery of pygopagus asymmetrical conjoined twins sharing U-shaped spinal cord: case report and literature review","volume":"29","author":"Hirokazu","year":"2013","journal-title":"Child\u2019s Nerv Syst"},{"key":"10.25259\/SNI_41_2025\/ref-8","doi-asserted-by":"crossref","first-page":"699","DOI":"10.1007\/s00381-012-2007-2","article-title":"Separation surgery of pygopagus asymmetrical conjoined twins sharing U-shaped spinal cord: Case report and literature review","volume":"29","author":"Hirokazu","year":"2013","journal-title":"Childs Nerv Syst"},{"key":"10.25259\/SNI_41_2025\/ref-9","doi-asserted-by":"crossref","first-page":"1949","DOI":"10.1007\/s00381-023-05912-5","article-title":"Separation of conjoined spinal cords in symmetrical pygopagus twins using intraoperative neuromonitoring: Pearls and pitfalls","volume":"39","author":"Mahmoud","year":"2023","journal-title":"Childs Nerv Syst"},{"key":"10.25259\/SNI_41_2025\/ref-10","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1002\/ajmg.c.30321","article-title":"Conjoined twins: A worldwide collaborative epidemiological study of the international clearinghouse for birth defects surveillance and research","volume":"157","author":"Mutchinick","year":"2011","journal-title":"Am J Med Genet Part C Semin Med Genet"},{"key":"10.25259\/SNI_41_2025\/ref-11","doi-asserted-by":"crossref","first-page":"814","DOI":"10.1002\/pd.1268","article-title":"Conjoined twins","volume":"25","author":"Spitz","year":"2005","journal-title":"Prenat Diagn"},{"key":"10.25259\/SNI_41_2025\/ref-12","doi-asserted-by":"crossref","first-page":"5","DOI":"10.3171\/CASE218","article-title":"Successful neurosurgical separation of conjoined spinal cords in pygopagus twins: Illustrative cases","volume":"1","author":"Yokota","year":"2021","journal-title":"J Neurosurg Case Lessons"}],"container-title":["Surgical Neurology International"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/surgicalneurologyint.com\/pygopagus-conjoined-twins-a-case-report-and-neurosurgical-nuances-in-separation-surgery\/","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/pygopagus-conjoined-twins-a-case-report-and-neurosurgical-nuances-in-separation-surgery\/","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T09:02:39Z","timestamp":1773392559000},"score":1,"resource":{"primary":{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/pygopagus-conjoined-twins-a-case-report-and-neurosurgical-nuances-in-separation-surgery\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,13]]},"references-count":12,"alternative-id":["10.25259\/SNI_41_2025"],"URL":"https:\/\/doi.org\/10.25259\/sni_41_2025","relation":{},"ISSN":["2152-7806","2229-5097"],"issn-type":[{"value":"2152-7806","type":"electronic"},{"value":"2229-5097","type":"print"}],"subject":[],"published":{"date-parts":[[2026,3,13]]},"article-number":"135"}}