Select Page

Twins conjoined at the spine undergo 15 hour surgery

Conjoined Twins

Photo credit: EL UNIVERSAL

Two Cascade Elite IONM systems were part of the tools used to separate conjoined seven-month-old twins in Mexico in September, 2015. Twins Maria and Melany Amayrany Guadalupe were born joined at the lower back and shared the spinal cord and sacrum, which compromised the central nervous system and the digestive system.

ConjoinedThe biggest challenge was the spinal cord. The surgery had a high risk of paraplegia. The multidisciplinary team of doctors separated nerve endings in each girl, and around 40 lumbar and sacral roots.

Neurosurgeon Felipe Gordillo spent four hours working with a 40x microscope and with the help of an additional team on two Cascade Elites identifying which nerve roots were connected to which girl. Nerves were stimulated separately and alternately, and continuous EMG was registered on the roots involved on the spine and sphincters throughout the procedure. Evoked EMG indicated by the surgeon identified nerve tissues and led surgical behavior.twins

The monitoring was a crucial part of the surgery, as surgeons tried to avoid possible sphincter dysfunction, paraplegia, sensory disturbances and spinal disorders.

With 30 specialists in neurosurgery, plastic surgery, physiology, pediatrics, gastroenterology and anesthesiology, and Cascade Elites dictating precious movements, the girls were successfully separated with full limb functionality and no neurological deficits.

Today, at 21 months, the twins are healthy, undergoing rehabilitation, and are learning to crawl.

See the original story.