{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T21:23:07Z","timestamp":1792790587836,"version":"4.5.0"},"reference-count":34,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","license":[{"start":{"date-parts":[[2025,2,10]],"date-time":"2025-02-10T00:00:00Z","timestamp":1739145600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Cosmet Laser Ther"],"published-print":{"date-parts":[[2025,2,10]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>A conjoined parasitic twin is a grossly defective fetus or fetal parts attached externally to a relatively normal twin. Rachipagus conjoined twins are fused at the spine. Conjoined twinning is an exceedingly uncommon congenital abnormality, with rachipagus twinning being the rarest variant.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>The authors report the case of a rare parasitic rachipagus conjoined twin who was surgically managed at 9 weeks of age. The patient presented with skin-covered swelling on her upper back that resembled digits. Further study with computed tomography showed parasitic content of the digits and embryonic tissue and the absence of posterior elements of the T4 and T5 vertebrae without meningocele at the autosite. The patient underwent successful excision of the parasitic twin and subsequently had normal growth and development.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>Neural tube defects of varying degrees occur in almost all rachipagus parasites, which should be taken into account in the comprehensive treatment of the pathology. Patients vary in the degree of fusion, and preoperative imaging to demonstrate the complex surgical anatomy at the fusion site should be an integral part of treatment. A multidisciplinary team consisting of neurosurgeons, pediatric surgeons, and plastic surgeons is required.<\/jats:p>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/thejns.org\/doi\/10.3171\/CASE24698\">https:\/\/thejns.org\/doi\/10.3171\/CASE24698<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case24698","type":"journal-article","created":{"date-parts":[[2025,2,10]],"date-time":"2025-02-10T01:50:05Z","timestamp":1739152205000},"source":"Crossref","is-referenced-by-count":2,"title":["A rare case of parasitic rachipagus conjoined twins: illustrative case"],"prefix":"10.3171","volume":"9","author":[{"given":"Seare Halefom","family":"Kahsay","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Mekelle University, Mekele, Tigray Region, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-9474-9964","authenticated-orcid":true,"given":"Yirgalem Teklebirhan","family":"Gebreziher","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Mekelle University, Mekele, Tigray Region, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"3","key":"bib1","series-title":"Clin Anat","first-page":"385","article-title":"Conjoined twins: from conception to separation, a review","volume":"30","author":"Mian","year":"2017","unstructured":"Mian AGabra NISharma TConjoined twins: from conception to separation, a review. Clin Anat. 2017;30(3):385-396."},{"issue":"8-9","key":"bib2","series-title":"Childs Nerv Syst","first-page":"508","article-title":"The embryology of conjoined twins","volume":"20","author":"Kaufman","year":"2004","unstructured":"Kaufman MH.The embryology of conjoined twins. Childs Nerv Syst. 2004;20(8-9):508-525."},{"issue":"6","key":"bib3","series-title":"Clin Anat","first-page":"428","article-title":"Parasitic conjoined twins: external, internal (fetuses in fetu and teratomas), and detached (acardiacs)","volume":"14","author":"Spencer","year":"2001","unstructured":"Spencer R.Parasitic conjoined twins: external, internal (fetuses in fetu and teratomas), and detached (acardiacs). Clin Anat. 2001;14(6):428-444."},{"issue":"6","key":"bib4","series-title":"Teratology","first-page":"346","article-title":"Rachipagus conjoined twins: they really do occur!","volume":"52","author":"Spencer","year":"1995","unstructured":"Spencer R.Rachipagus conjoined twins: they really do occur! Teratology. 1995;52(6):346-356."},{"key":"bib5","series-title":"Interdiscip Neurosurg","article-title":"Rachipagus parasitic twins: a case series and review of literature","volume":"24","author":"Zewdie","year":"2021","unstructured":"Zewdie KNegash SBizuneh YWoldemichael FTemesgen F.Rachipagus parasitic twins: a case series and review of literature. Interdiscip Neurosurg. 2021;24:101049."},{"issue":"3","key":"bib6","series-title":"Acta Neurochir","first-page":"611","article-title":"Parasitic twin\u2014a supernumerary limb associated with spinal malformations. A case report","volume":"158","author":"Sahlu","year":"2016","unstructured":"Sahlu AMesfin BTirsit ADebebe TWester K.Parasitic twin\u2014a supernumerary limb associated with spinal malformations. A case report. Acta Neurochir. 2016;158(3):611-614."},{"issue":"3","key":"bib7","series-title":"J Neurosurg Pediatr","first-page":"313","article-title":"Parasitic rachipagus conjoined twin: case report","volume":"22","author":"Khavanin","year":"2018","unstructured":"Khavanin NRuge JRVicari FABelin EJKellogg RGSteinberg JP.Parasitic rachipagus conjoined twin: case report. J Neurosurg Pediatr. 2018;22(3):313-316."},{"issue":"3","key":"bib8","series-title":"Sri Lanka J Child Health","article-title":"A rare case of heterophagus twinning","volume":"47","author":"Priyawansha","year":"2018","unstructured":"Priyawansha YGTMunasinghe KDManike N.A rare case of heterophagus twinning. Sri Lanka J Child Health. 2018;47(3):279."},{"issue":"1","key":"bib9","series-title":"Egypt Spine J","first-page":"48","article-title":"Dorsolumbar parasitic rachipagus twin, case report","volume":"19","author":"Awad","year":"2016","unstructured":"Awad TElsayem KElqazaz M.Dorsolumbar parasitic rachipagus twin, case report. Egypt Spine J. 2016;19(1):48-54."},{"issue":"3","key":"bib10","series-title":"Childs Nerv Syst","first-page":"529","article-title":"Notomelia and related neural tube defects in a baby born in Niger: case report and literature review","volume":"33","author":"Kelani","year":"2017","unstructured":"Kelani ABMoumouni HIssa AWNotomelia and related neural tube defects in a baby born in Niger: case report and literature review. Childs Nerv Syst. 2017;33(3):529-534."},{"issue":"3","key":"bib11","series-title":"Pak","first-page":"54","article-title":"Vestigial accessory limbs with spina bifida: our 5-year experience","volume":"20","author":"Ijaz","year":"2016","unstructured":"Ijaz LNadeem MMRehman LU.Vestigial accessory limbs with spina bifida: our 5-year experience. Pak J Neurol Surg. 2016;20(3):54-57."},{"issue":"2","key":"bib12","series-title":"Ann Afr Surg","first-page":"187","article-title":"Parasitic rachipagus conjoined twins: surgical management and follow-up of a case in Kenya","volume":"11","author":"Oduor","year":"2014","unstructured":"Oduor PRNyamal K.Parasitic rachipagus conjoined twins: surgical management and follow-up of a case in Kenya. Ann Afr Surg. 2014;11(2):187-191."},{"issue":"10","key":"bib13","series-title":"Neurol Med Chir (Tokyo)","first-page":"736","article-title":"Parasitic rachipagus conjoined twins with spina bifida, diplomyelia, scoliosis, tethered cord syndrome, and ventricular septal defect\u2014case report","volume":"51","author":"Zhang","year":"2011","unstructured":"Zhang JDuan HZhang YYi ZBao S.Parasitic rachipagus conjoined twins with spina bifida, diplomyelia, scoliosis, tethered cord syndrome, and ventricular septal defect\u2014case report. Neurol Med Chir (Tokyo). 2011;51(10):736-739."},{"issue":"1","key":"bib14","series-title":"J Surg Tech Case Rep","article-title":"Rachipagus: a report of two cases\u2014thoracic and lumbar","volume":"2","author":"Sanoussi","year":"2010","unstructured":"Sanoussi SRachid SSani CMMahamane BAddo G.Rachipagus: a report of two cases\u2014thoracic and lumbar. J Surg Tech Case Rep. 2010;2(1):27-29."},{"key":"bib15","series-title":"J Pediatr Surg Case Rep","first-page":"44","article-title":"Heteropagus (parasitic) twins","volume":"37","author":"Dejene","year":"2018","unstructured":"Dejene BNegash SAMammo TNTadesse AGetachew HDerbew M.Heteropagus (parasitic) twins. J Pediatr Surg Case Rep. 2018;37:44-49."},{"issue":"4","key":"bib16","series-title":"Am J Med Genet C Semin Med Genet","first-page":"274","article-title":"Conjoined twins: a worldwide collaborative epidemiological study of the International Clearinghouse for Birth Defects Surveillance and Research","volume":"157C","author":"Mutchinick","year":"2011","unstructured":"Mutchinick OMLuna-Mu\u00f1oz LAmar EConjoined twins: a worldwide collaborative epidemiological study of the International Clearinghouse for Birth Defects Surveillance and Research. Am J Med Genet C Semin Med Genet. 2011;157C(4):274-287."},{"issue":"9","key":"bib17","series-title":"J Pediatr Surg","first-page":"1357","article-title":"Parasitic omphalopagus complicated by omphalocele and congenital heart disease","volume":"37","author":"de Ugarte","year":"2002","unstructured":"de Ugarte DABoechat MIShaw WWLaks HWilliams HAtkinson JB.Parasitic omphalopagus complicated by omphalocele and congenital heart disease. J Pediatr Surg. 2002;37(9):1357-1358."},{"issue":"3","key":"bib1","series-title":"Clin Anat","first-page":"385","article-title":"Conjoined twins: from conception to separation, a review","volume":"30","author":"Mian","year":"2017","unstructured":"Mian AGabra NISharma TConjoined twins: from conception to separation, a review. Clin Anat. 2017;30(3):385-396."},{"issue":"8-9","key":"bib2","series-title":"Childs Nerv Syst","first-page":"508","article-title":"The embryology of conjoined twins","volume":"20","author":"Kaufman","year":"2004","unstructured":"Kaufman MH.The embryology of conjoined twins. Childs Nerv Syst. 2004;20(8-9):508-525."},{"issue":"6","key":"bib3","series-title":"Clin Anat","first-page":"428","article-title":"Parasitic conjoined twins: external, internal (fetuses in fetu and teratomas), and detached (acardiacs)","volume":"14","author":"Spencer","year":"2001","unstructured":"Spencer R.Parasitic conjoined twins: external, internal (fetuses in fetu and teratomas), and detached (acardiacs). Clin Anat. 2001;14(6):428-444."},{"issue":"6","key":"bib4","series-title":"Teratology","first-page":"346","article-title":"Rachipagus conjoined twins: they really do occur!","volume":"52","author":"Spencer","year":"1995","unstructured":"Spencer R.Rachipagus conjoined twins: they really do occur! Teratology. 1995;52(6):346-356."},{"key":"bib5","series-title":"Interdiscip Neurosurg","article-title":"Rachipagus parasitic twins: a case series and review of literature","volume":"24","author":"Zewdie","year":"2021","unstructured":"Zewdie KNegash SBizuneh YWoldemichael FTemesgen F.Rachipagus parasitic twins: a case series and review of literature. Interdiscip Neurosurg. 2021;24:101049."},{"issue":"3","key":"bib6","series-title":"Acta Neurochir","first-page":"611","article-title":"Parasitic twin\u2014a supernumerary limb associated with spinal malformations. A case report","volume":"158","author":"Sahlu","year":"2016","unstructured":"Sahlu AMesfin BTirsit ADebebe TWester K.Parasitic twin\u2014a supernumerary limb associated with spinal malformations. A case report. Acta Neurochir. 2016;158(3):611-614."},{"issue":"3","key":"bib7","series-title":"J Neurosurg Pediatr","first-page":"313","article-title":"Parasitic rachipagus conjoined twin: case report","volume":"22","author":"Khavanin","year":"2018","unstructured":"Khavanin NRuge JRVicari FABelin EJKellogg RGSteinberg JP.Parasitic rachipagus conjoined twin: case report. J Neurosurg Pediatr. 2018;22(3):313-316."},{"issue":"3","key":"bib8","series-title":"Sri Lanka J Child Health","article-title":"A rare case of heterophagus twinning","volume":"47","author":"Priyawansha","year":"2018","unstructured":"Priyawansha YGTMunasinghe KDManike N.A rare case of heterophagus twinning. Sri Lanka J Child Health. 2018;47(3):279."},{"issue":"1","key":"bib9","series-title":"Egypt Spine J","first-page":"48","article-title":"Dorsolumbar parasitic rachipagus twin, case report","volume":"19","author":"Awad","year":"2016","unstructured":"Awad TElsayem KElqazaz M.Dorsolumbar parasitic rachipagus twin, case report. Egypt Spine J. 2016;19(1):48-54."},{"issue":"3","key":"bib10","series-title":"Childs Nerv Syst","first-page":"529","article-title":"Notomelia and related neural tube defects in a baby born in Niger: case report and literature review","volume":"33","author":"Kelani","year":"2017","unstructured":"Kelani ABMoumouni HIssa AWNotomelia and related neural tube defects in a baby born in Niger: case report and literature review. Childs Nerv Syst. 2017;33(3):529-534."},{"issue":"3","key":"bib11","series-title":"Pak","first-page":"54","article-title":"Vestigial accessory limbs with spina bifida: our 5-year experience","volume":"20","author":"Ijaz","year":"2016","unstructured":"Ijaz LNadeem MMRehman LU.Vestigial accessory limbs with spina bifida: our 5-year experience. Pak J Neurol Surg. 2016;20(3):54-57."},{"issue":"2","key":"bib12","series-title":"Ann Afr Surg","first-page":"187","article-title":"Parasitic rachipagus conjoined twins: surgical management and follow-up of a case in Kenya","volume":"11","author":"Oduor","year":"2014","unstructured":"Oduor PRNyamal K.Parasitic rachipagus conjoined twins: surgical management and follow-up of a case in Kenya. Ann Afr Surg. 2014;11(2):187-191."},{"issue":"10","key":"bib13","series-title":"Neurol Med Chir (Tokyo)","first-page":"736","article-title":"Parasitic rachipagus conjoined twins with spina bifida, diplomyelia, scoliosis, tethered cord syndrome, and ventricular septal defect\u2014case report","volume":"51","author":"Zhang","year":"2011","unstructured":"Zhang JDuan HZhang YYi ZBao S.Parasitic rachipagus conjoined twins with spina bifida, diplomyelia, scoliosis, tethered cord syndrome, and ventricular septal defect\u2014case report. Neurol Med Chir (Tokyo). 2011;51(10):736-739."},{"issue":"1","key":"bib14","series-title":"J Surg Tech Case Rep","article-title":"Rachipagus: a report of two cases\u2014thoracic and lumbar","volume":"2","author":"Sanoussi","year":"2010","unstructured":"Sanoussi SRachid SSani CMMahamane BAddo G.Rachipagus: a report of two cases\u2014thoracic and lumbar. J Surg Tech Case Rep. 2010;2(1):27-29."},{"key":"bib15","series-title":"J Pediatr Surg Case Rep","first-page":"44","article-title":"Heteropagus (parasitic) twins","volume":"37","author":"Dejene","year":"2018","unstructured":"Dejene BNegash SAMammo TNTadesse AGetachew HDerbew M.Heteropagus (parasitic) twins. J Pediatr Surg Case Rep. 2018;37:44-49."},{"issue":"4","key":"bib16","series-title":"Am J Med Genet C Semin Med Genet","first-page":"274","article-title":"Conjoined twins: a worldwide collaborative epidemiological study of the International Clearinghouse for Birth Defects Surveillance and Research","volume":"157C","author":"Mutchinick","year":"2011","unstructured":"Mutchinick OMLuna-Mu\u00f1oz LAmar EConjoined twins: a worldwide collaborative epidemiological study of the International Clearinghouse for Birth Defects Surveillance and Research. Am J Med Genet C Semin Med Genet. 2011;157C(4):274-287."},{"issue":"9","key":"bib17","series-title":"J Pediatr Surg","first-page":"1357","article-title":"Parasitic omphalopagus complicated by omphalocele and congenital heart disease","volume":"37","author":"de Ugarte","year":"2002","unstructured":"de Ugarte DABoechat MIShaw WWLaks HWilliams HAtkinson JB.Parasitic omphalopagus complicated by omphalocele and congenital heart disease. J Pediatr Surg. 2002;37(9):1357-1358."}],"container-title":["Journal of Neurosurgery: Case Lessons"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/9\/6\/article-CASE24698.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/9\/6\/article-CASE24698.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/9\/6\/article-CASE24698.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T23:36:38Z","timestamp":1770075398000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/9\/6\/article-CASE24698.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,10]]},"references-count":34,"journal-issue":{"issue":"6"},"URL":"https:\/\/doi.org\/10.3171\/case24698","relation":{},"ISSN":["2694-1902"],"issn-type":[{"value":"2694-1902","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,10]]}}}