Conjoined twins, Joshua and Jacob Spates, were separated successfully at Le Bonheur Children’s Hospital, Memphis, on August 29th. Conjoined twins are identical twins who do not fully separate when they are in the uterus. This occurs in about 1 in every 100,000 births. Jacob and Joshua were joined back to back at the pelvis and lower spine – they are pygopagus twins. They have separate limbs, heads and hearts.

According to local doctors, there are only six cases of pygopagus twins in the history of Memphis.

The babies share a rectum, nerves and muscles. They were born joined at the lumbar sacral spine. When the mother was 25 weeks pregnant, doctors diagnosed the boys’ condition with an ultrasound scan. They were referred to Bonheur’s Fetal Center, where its medical director, Dr. Giancarlo Mari, established a plan of care. The boys were delivered at 34 weeks on January 24th this year via C-section.

They were born at The Regional Medical Center and then moved to Le Bonheur’s Neonatal ICU (intensive care unit). Within two days a colostomy was performed and a gastrostomy tube was inserted to facilitate feeding and the elimination of waste.

The next seven months were spent caring for Joshua and Jacob and preparing them for their separation. The babies were born with congenital anomalies:

  • Joshua was diagnosed with
    complications of situs inversus totalis
    A heart defect
    A single kidney
    Calcifications in the spleen
  • Jacob was diagnosed with
    Hydrocephalus
    A heart defect
    Dandy-Walker syndrome
    Hydrocephalus
    Two-vessel umbilical cord

An array of health care professionals was involved in caring for the twins, including anesthetists, surgeons of various specialties, neonatologists, nurses, rehabilitation therapists, and social workers.

The surgical separation procedure lasted 13-hours. They separated the spinal column, spinal cord, muscles and carried out repairs in their gastrointestinal systems.

Meri Armour, Le Bonheur president and CEO, said:

“This collaboration of physicians and specialists is the absolute proof of success from years of national recruitment of the best. For our team to have successfully separated a case of this complexity and do it flawlessly is a major milestone in health care for the city of Memphis and the region.”

Jacob and Joshua will remain at the Le Bonheur’s PICU (pediatric intensive care unit) where they will receive critical care as well as rehabilitation therapy.

Written by Christian Nordqvist