Rudimentary third lower limb in association with spinal dysraphism: Two cases

Abstract

Spinal dysraphism is a common congenital anomaly with many associated variants. One of the rarest associated findings is a full grown or rudimentary third limb, collectively called Tripagus. We present two cases of spinal dysraphism with rudimentary third limb arising from the ilium.

Adult with sacral lipomyelomeningocele covered by an anomalous bone articulated with iliac bone: Computed tomography and magnetic resonance images

“…Our patient had a sacral dysraphism and a lipomyelomeningocele covered by an anomalous bone. This is similar to a report by Wasnik et al. (2007), which described two children with lower extremity weakness caused by lipomeningoceles associated with anomalous bone struts.…”

“…This is similar to a report by Wasnik et al (2007), which described two children with lower extremity weakness caused by lipomeningoceles associated with anomalous bone struts. Wasnik et al (2007) named this bone strut a 'rudimentary accessory limb'. However, a review of the literature involving an accessory limb associated with spinal dysraphism (Krishra et al 1989;Parkinson 1991;Krishna and Lal 1999) revealed that the accessory limbs had skin, muscle, long bones and digits, thus the structures were indisputably limbs.…”

Lumbosacral lipomyelomeningocele with anomalous osseous limb in a 3-month-old female

“…Our patient, with documented intrauterine meningocele, presented at birth with a lipomyelomeningocele at the lumbar-sacral level associated with an osseous appendage. Similar anomalous findings have been reported previously by Lee et al and Wasnik et al ( 4 , 5 ). Wasnik et al described the appendage as a “rudimentary accessory limb,” while Lee et al argued that because of the absence of limb structures such as muscle, long bones, and digits, a more accurate moniker would be “anomalous bone associated with spinal dysraphism.” A number of similar cases have been previously described since 1975 ( 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 ).…”

Lumbosacral Parasitic Twin Associated with Lipomeningomyelocele: A Rare Occurrence

“…Since no neurological deficit was present when the baby first presented, we deferred the surgery when the baby was 3 days old. Nontreatment may lead to neurological deficits like paraparesis or bladder and bowel incontinence [3]. Hence, surgery may not be postponed for a long time.…”

“…This is a very rare entity. In the case of lumbosacral twinning, it may be associated with neural tube defects like lipomeningomyelocele (LMMC) [2,3]. We happened to come across one such patient.…”