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A 10-month-old girl who was born with four legs and two spines is doing remarkably well following a complex surgery that took place on March 8. IBJI’s Eric Belin, M.D., was the orthopedic surgeon on the surgical team assembled to operate on Dominique, an infant born in west Africa with an exceptionally rare condition.

Dominique’s mother had been expecting twins, but one of the babies did not survive the pregnancy. Instead, that twin’s partially developed body attached itself to Dominique in utero, conjoining the two at their spines. The partial development of the “parasitic conjoined twin” resulted in Dominique being born with her twin’s pelvis and legs protruding from her neck and back. “This was a very, very rare case,” explained Dr. Belin, who is an orthopedic spine specialist.

A charitable organization that helps children with exceptional medical needs obtain treatment in the U.S. first brought Dominique’s condition to the attention of doctors in Chicago. Children’s Medical Mission West reached out to John Ruge, M.D., a pediatric neurosurgeon at Advocate Children’s Hospital in Park Ridge. He then assembled the surgical team for Dominique’s treatment. “Dr. Ruge asked me to serve as the orthopedic spine surgeon on the surgical team of five physicians that included two pediatric neurosurgeons and two pediatric plastic/reconstructive surgeons and myself,” said Dr. Belin.

Dr. Belin agreed to join the team, knowing that there was no precedent for what they were about to do. To prepare for the complex procedure, the surgeons created a 3-D model of Dominique so that they could analyze the way in which the tiny bodies were conjoined and begin to map a surgical plan to remove the parasitic twin.

Critical to the team’s success would be ensuring that Dominique’s spine could develop properly, explained Dr. Belin. “One of the big worries was that there was no bone around Dominique’s two spinal columns, other than the pelvic bone from the parasitic twin that connected the two. We didn’t want to leave her with an unstable spine because that could be devastating. Part of our planning process involved using the 3-D model to figure out just how much bone from the additional pelvis we would need to leave so that we could maintain that stability to her spine. Going into the surgery, our team was hopeful, but we realized how exceedingly challenging this would be.”

There were many risks to removing the parasitic twin, according to Dr. Belin, who has a young son not much older than Dominique. “Our team worked to identify all of those potential dangers so that we could minimize the risks to this little girl. After six hours in surgery, we were thrilled to report that the procedure was an incredible success. Today, Dominique is thriving and we are expecting that she will be able to live a fully functional life.”

Dominique is currently being cared for by a host family in Chicago’s Edgebrook neighborhood. The family reports that Dominique is already sitting up and playing, just two weeks after surgery. She will eventually return home to be reunited with her biological parents in Africa’s Ivory Coast once her recovery is complete.

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