Abstract
Background: Multiple neural tube defects are rare congenital anomalies resulting from failure of neural tube closure at multiple sites. Double meningomyelocele is extremely uncommon, with very few cases reported worldwide.
Case presentation: An 11-day-old female neonate presented with two midline swellings over the dorsolumbar region since birth. MRI revealed dual meningomyeloceles at D12–L2 and L5–S1 levels with associated Chiari II malformation. The child underwent single-stage surgical repair with excision of both sacs, detethering, neurulation, and sectioning of filum terminale.
Management and outcome: Both lesions were successfully repaired in one sitting without intraoperative neuromonitoring. Postoperatively, the child had an uneventful recovery with no new neurological deficits.
Conclusion: Double meningomyelocele is an extremely rare entity. Careful radiological evaluation, meticulous surgical technique, and complete detethering are essential. Single-stage repair is safe and effective even in resource-limited settings.
Key message: Double meningomyelocele is exceedingly rare. Single-stage repair with meticulous neural placode detethering and filum terminale section—despite resource constraints—can yield excellent outcomes. Early recognition and comprehensive MRI evaluation are essential for surgical planning and parental counselling.
