Introduction: Pygopagus conjoined twins are joined at the rump and have union of the gastrointestinal and genitourinary systems as well occasional involvement of neural elements.
Case report: We report a case where the terminal spinal cords were fused, despite which there was only a minor motor deficit in the lower limbs after separation. The pre-operative and intra-operative findings are described and issues of long-term follow-up discussed.
Discussion: Seven other cases reported in the literature with varying degrees of involvement of the spinal cord and cauda equina are reviewed.