Accessory limb with myelomeningocele: a rare case challenging previously held beliefs

There have been previous reports of intra-scapular limbs associated with a closed spina bifida and this has led to a causative theory. It is thought that these dysraphic appendages could not occur with defects of primary neurulation. The authors present a rare case of this abnormality associated with a large open myelomeningocele in a 6-day-old infant presenting to a paediatric neurosurgical hospital in Uganda. The appendage was removed and the spina bifida closed. There was significant stigma associated with such abnormality in this region. The first reported co-existence of these two lesions challenges previously held beliefs regarding the embryological origin of intra-scapular dysraphic appendage.