Background Data: Siamese twins are joined by a part of their body at birth and the causes of the merger are often unknown. When the merger is on the spine it is rachipagus. It is an extremely rare and strange condition, and
there are only a few documented cases in the literature. We present one additional case of parasite rachipagus on the dorsolumbar level. Purpose: Our aim is to describe a girl with a parasitic twin attached to her lower back, combined with a spina bifida and a lipomyelomeningocele. Study Design: Case report and review of the literature Patient and Method: In September 2014, a female baby from North Sinai was referred to Suez Canal University Hospital. She was 1 month old and had an extra well developed parasitic twin attached to her back. She was surgically treated in the Neurosurgery and Pediatric Surgery Departments. Results: A rare example of rachipagus conjoint parasitic twinning in a newborn girl is described. A lipomatous mass, a rudimentary intestinal loop with an attached atrophic pelvis and hind limb were found adherent to the dorsal vertebral arches of the autosite in the thoracolumbar region. Surgical excision of the parasitic twin, excision of the dorsal lipoma, repair of the cord and wound repair were done Conclusion: Parasitic rachipagus is a rare embryogenic malformation with a good surgical prognosis on the autosite in the absence of associated congenital anomalies. (2016ESJ111)