Vestigial Accessory Limbs with Spina Bifida: Our 5 – Year Experience

Abstract

Background: Accessory limb on the back of trunk with spina bifida is an exceedingly rare entity which has perplexing morphogenesis. We are sharing our 5 – years’ experience of managing 5 patients with accessory vestigial limbs on the back associated with spina bifida.
Materials and Methods: The medical record of 5 patients with accessory limbs on the back of the trunk was reviewed for mode of presentation, investigations, management, and outcome.
Results: There were 5 infants, one was male while rest were females (M: F = 1: 4). Ages ranged from 1.5month to 1 year (mean age 6.3 months). All patients presented with a vestigial limb attached to the lumbosacral region. One patient had anal pit like depression on the vestigial accessory limb. Every patient had associated spina bifida. One patient had associated lipomeningocele. Another patient had associated right clubfoot. All patients were investigated with X-rays and MRI and underwent excision of the accessory limbs. One patient developed wound dehiscence and CSF leak post-operatively which settled on conservative management. Stillanother patient had repeated wound infections and is booked for release of tethered spinal cord. All patients survived. Two patients required physiotherapy for lower limb weakness.
Conclusion: Accessory limbs on the back are quite rare anomalies and are associated with a number of other anomalies. It is more common in females. The anomaly is a psychosocial dilemma for the parents. Early excision is necessary to allay the anxiety of the parents