Jacob And Joshua Spates, Conjoined At The Pelvis, Separated After 13-Hour Surgery

Tennessee surgeons have successfully separated conjoined twins, Jacob and Joshua Spates, who were connected at the lower spine and pelvis.

The twins' mother, Adrienne Spates, told TODAY that the twins are doing well after the 13-hour Aug. 29 surgery: Jacob is in the intensive care unit and is scheduled for some additional surgeries, while Joshua is now in the recovery floor of the hospital and will soon come home.

"Joshua's doing great, and hopefully he'll be up and going and have a pretty normal lifespan," Dr. Max Langham, one of the twins' surgeons at Le Bonheur Children's Hospital, told TODAY. Jacob, who has heart problems, still has to undergo treatments and surgeries, but "our cardiology team has very high hopes his treatment … will be successful," Langham said.

The twins were born at 34 weeks old last January. They were conjoined from the back at the pelvis and the lower section of the gastrointestinal tract, TODAY reported. However, they had their own hearts, heads, chests, legs, arms and other important internal organs, so they are very much "two different boys," Spates said.

The separation of the twins was necessary in order for doctors to repair Jacob's heart condition, Langham told TODAY.

"If they had not been separated, sometime in the next year or two, they probably would have passed," Langham said. He added that the hardest part of the surgery was the neurosurgical separation of the twins' pelvis and lower spinal cord.

There were more than 100 surgeons involved in the medical team to separate the twins. The surgeons practiced for the surgery on sewn-together Cabbage Patch dolls, to make sure they didn't tangle things up during the actual surgery, according to Prime News.

The twins are one of two dozen conjoined twins who have been successfully separated in the world, ABC News reported. Only about 15 percent of conjoined twins are connected the same way the Spates were, at the pelvis -- called pygopagus twins.

Conjoined twins are extremely rare, accounting for just 1 percent of monozygotic twins, according to Medscape. Monozygotic twins is a type of twin that only makes up a third of twin births; twin births are already rare, and happen in just 1 of every 87 births. Conjoined twins make up one of every 33,000 to 165,000 births in the United States, and one of every 200,000 live births, Medscape reported.

Most conjoined twins are fused at the abdomen or the thorax (between the head and the abdomen), Medscape reported. Conjoined twins are either "equal conjoined" twins -- meaning they're both well developed separately -- or "unequal conjoined" twins -- meaning one of the twins is incomplete and is attached to the more fully developed twin.

Live-born conjoined twins are more commonly girls, while stillborn conjoined twins are more commonly boys, according to Medscape. It's common for conjoined twins to be born stillborn, with stillborn births occurring 40 to 60 percent of the time in cases of conjoined twins.

Comments

[CUvodkaSiasLPN]

06:04 AM on 09/15/2011

Pregnant moms to be don't panic and I say this with love and understanding. When I found out I was having twins, it seemed that every show imaginable had a topic relating to being conjoined or one dying and the other surviving. Their dad was always walking in the room or waking up to find me glued to the t.v. with a furrowed brow. I was so silly and scary. Best of health to the mom and the babies.

[Linda Reiber]

05:47 AM on 09/15/2011

My heart and prayers go out to this mother and her family. Its amazing what drs. can do these days...and I pray that these little boys will be able to be home with their family really soon. Bless
the family...and give them strength...I know God is with them and will help them through this...

[GaelMc]

04:40 AM on 09/15/2011

What a difficult decision. The mother has my heart felt support for the ordeal that still faces her. Well done medical team.

[Kiran Khan]

02:04 AM on 09/15/2011

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[AJ Woodruff]

05:01 AM on 09/15/2011

Khaaaaaaaaaan!

[andrwsroe]

12:58 AM on 09/15/2011

THIS ARTICLE SHOWS US JUST HOW GOOD OUR MEDICAL SYSTEM REALLY IS. WHAT IF THIS HAD HAPPENED ID CHINA? CUBA? OR ANY THRID WORLD COUNTRY?
THREE WEEKS AGO I HAD A 3 HR OPERATION ON MY SPINE FOR SPINAL STENOSIS AND I AM ALREADY BACK AT WORK. IT IS HARD TO COMPREHEND A 13 HR. OPERATION.
NO I AM NOT RICH. I AM A MACHINIST FOR A SMALL MEDICAL REPAIR COMPANY WITH JUST AVERAGE MED. INS.

[allerleirauh]

12:50 AM on 09/15/2011

Regarding how the operation was paid for, from the Memphis Commercial Appeal:

Figures on the cost of the operation were unavailabl­e Wednesday, but it's a "huge number," Langham said. Although Medicaid will cover much of the cost, a fund -- called the Joshua and Jacob Spates Trusts -- has been establishe­d at First Tennessee Bank to help pay for supplement­al assistance for the boys.

[dx3shl]

12:48 AM on 09/15/2011

We serve a wonderful God. He is amazing and I pray His will be done in the lives of these small miracles. I pray for their mother who with the blessings and will of Our Father she'll raise two young men, who will have the opportunity to make a major difference in the world.

[Hpotterfan77]

12:49 PM on 09/15/2011

Who's "we"?

[walkingwolf]

11:36 PM on 09/14/2011

Great job Doctors...and I hope the mother is resting with a little peace of mind now after that long grueling ordeal...

[larkjgb1]

11:34 PM on 09/14/2011

All of you who are ranting about insurance: the article says nothing concerning the family's insurance. You are making assumptions. They may have private insurance, and they may have a payment plan to pay for what their insurance doesn't cover. Why don't you quit using this article to rag on each other's politics and rejoice that these children were helped?

[loveis22984]

11:56 PM on 09/14/2011

because they are EVIL.

[allerleirauh]

12:48 AM on 09/15/2011

Maybe I can help clear up some of these questions. I'm from Memphis where the surgery was performed, so we have more coverage here. From the Memphis Commercial Appeal:

Figures on the cost of the operation were unavailable Wednesday, but it's a "huge number," Langham said. Although Medicaid will cover much of the cost, a fund -- called the Joshua and Jacob Spates Trusts -- has been established at First Tennessee Bank to help pay for supplemental assistance for the boys.

[mhoffman79843791]

10:59 PM on 09/14/2011

This is a clear example as to why we need universal health care in this country like Canada and many western European nations have for their citizens. Employer based health insurance is not working. First of all most businesses do not want to pay for insurance for their employees. People who are lucky enough to have health insurance through their employer, have to pay large copays, because their employer will only buy the cheapest health insurance out there, to save their precious profit margins. Public employees usually have better insurance than private sector employees, but they receive smaller salaries than private sector employees. Despite what the teabaggers allege, public sector employees generally earn less than private sector employees, performing comparative work. Public sector employees accept the smaller salary in exchange for the benifits they receive.
Social Security and Medicare are not entitlement programs as the teabaggers allege. Everyone pays into Social Security and Medicare. If you do not pay into it, then you will not collect any benifits at retirement.

[OHnative]

12:13 AM on 09/15/2011

Umm, maybe if patients had a stake in the cost of the medical procedures, were expected to pay for flu shots and annual checkups out of pocket, then perhaps a plan for catastrophic care would be much more affordable.

Once again, progressives believe that universal health care is the answer in which unelected, unaccountable and faceless bureaucrats decide who qualifies for care and who does not...al in the name of saving dimes for the government.

Insurance is not a right. But mhoffman might be interested in learning that elective procedures: hair transplants, lasik, tummy tucks, all cost less today than they did 15 years ago...and they're technology has improved!! Why?? Because the patient pays out of pocket and takes ownership of shopping for the best price.

More Americans could afford an emergency plan and could pay out of pocket for flu shots, annual checkups--just like we all do for car insurance!--if we only allow the free market to work like car insurance.

Geico, AllState, Nationwide, and how many other competitive bids exist for car insurance?

But Hoffman thinks the ONLY solution is the Over-promising and Under-delivering Government. The same one that once its solution fails, the only option is MORE govt and more spending and more taxes until we all look like Greece, Venezuela or Great Britain.

IN any of those cases, private property is destroyed and its citizens are enslaved to Big Daddy Government.

[AlyceMD3]

01:37 AM on 09/15/2011

As I understand it, people with DUI's either can't get auto insurance, or have to pay exorbitant costs, or they legally can't drive. If you have a pre-existing medical condition, you will not be able to get health insurance, or you will pay even more exorbitant prices for health insurance with bare bones coverage. Does that mean you can't live legally?

[dukie1955]

02:38 AM on 09/15/2011

Obviously you are not on medicare and have little knowledge of how it works. I've been on Medicare for 12 years. I have had knee and back surgery and have not had one single problem with unelected, unaccounta­ble and faceless bureaucrat­s. My son has insurance with BlueCross - unelected, unaccounta­ble and faceless insurance bureaucrat­s refused to pay for a medical checkup saying it was "an existing condition," refused to pay for a minor operation because it was "an existing condition," and would not pay for one of his medications. The problem for people with insurance is that insurance companies are in business to make as much profit as possible and those who decide what to pay for get bonuses for saving the company money. With Medicare, us tax payers get ripped-off by bogus charges to Medicare by doctors and businesses that are not caught by the government.

[AbbyAbby]

04:02 AM on 09/15/2011

Actually, this is a good example of how our current system works just fine. Here is a family with a gigantic medical bill and no personal helath coverage and we ALREADY have a system in place to take care of it and they got superior care. This is a shining example of how the system is supposed to work. Why would we want to change it? Would you really prefer that the twins be put on a waiting list for their surgeries? Under universal care, the hospitals and clinics, etc. have a BUDGET and performing one surgery like this would mean that hundreds of minor surgeries would have to be pushed into the next fiscal year. One of them might be yours. Or your kids'.

[FiredUpRTG]

09:50 AM on 09/15/2011

Change doesn't have to be bad. How about changing things for the better? Too many people fall through the cracks.

[beth2216]

09:37 PM on 09/14/2011

Those complaining about them having medical assistance need a little education. If you were in the same situation and needed help you would apply for it to. There are times when it suppliments your current insurance. I am glad that my son was able to qualify for medical assistance. He has congenital heart disease and is constantly going for tests and appointments. There's no way my husbands insurance would cover any of these. We wouldn't be able to have enough money to pay the bills either (due to the fact that I had to leave my job to take care of my son). Just a glimpse inside how much a surgery can cost: the day my son had open heart surgery was over $69,000!!! That was 1 day!!! That's not including the other 33 days he spent in the hospital with all of the tests and x-rays that he received, plus all of the cardiologist visits and tests that he's doing right now... I am glad that my husbands (and mine when I was working) taxes go to things like this. I rather my taxes go to medical care instead of other programs (not that others are bad, but everyone needs to go to the dr sometime in their life). I am just glad that these boys came out of this well. I hope that the other son in ICU heals and can join his brother. (and if they do receive medical assistance- AWESOME!!!!)

[AngelaQuattrano]

10:00 PM on 09/14/2011

None but the wealthiest could afford to pay the costs of such an accident of birth. Those who post such nonsense represent a citizen's death panel to kill the sick and weak by denying them life-saving health care.

[beth2216]

10:17 PM on 09/14/2011

I don't think they necessary want to kill the sick and weak, but they haven't gone through situations where you need things like medical assistance...so they think that since they are not going through it, then they shouldn't help anyone else...I wouldn't wish things like this on anyone...It's a very hard situation to deal with...

[dtruckdrivinfool]

09:36 PM on 09/14/2011

Seems one of them has external organs to address and one has an undeveloped brain.

[bouvdoggie]

09:49 PM on 09/14/2011

Where did you get that information? The article said they both had completely separate heads and all their organs were completely formed and separate. The only parts that were joined were at their pelvis and the bottom of their spine

[flowerlei]

12:52 AM on 09/15/2011

I am with you. Someone read something that we did not see.

[daradar]

03:57 AM on 09/15/2011

In a medical report from the twins doctor on national tv, it was stated the one twin is hydrocephalic and has a severe heart defect, which would have killed the twins in the coming months. The severe heart defect was the reason to separate the children now. Heart surgeons are working on a plan to try and repair the problem in the twin.

[FiredUpRTG]

09:55 AM on 09/15/2011

The mom did infer that they were separated so that one could do his thing.

[ljconner]

09:26 PM on 09/14/2011

LeBonheur Children's Hospital is an excellent facility here in Memphis, Tennessee.
We are very proud of their work and dedication.

[bouvdoggie]

09:15 PM on 09/14/2011

Get the operation or they both die? That makes it simple. If she had to make a choice then it would be terrible. I hope they do well but what about the kids father? Is he doing well or has he skipped his responsiblities? I hate it when we are only getting one parent's voice.

[FiredUpRTG]

09:56 AM on 09/15/2011

Father's job is to stand around and look goofy. I'm sure this is an area he doesn't understand. Women's issues, children… gosh.

[lilierosa]

08:52 PM on 09/14/2011

who cares?????????? I pay taxes and will gladly pay more so everyone in this country receives the same quality of medical care. The fact that you think this family should not receive this care because they MAY not have health care makes you unAmerican and a human that should not procreate. We do not need you - moan, moan moan, yet do nothing to help fix things.

[AlyceMD3]

01:41 AM on 09/15/2011

As a terminally ill person on Medicare, I thank you from the bottom of my heart.

[FiredUpRTG]

09:57 AM on 09/15/2011

It's cheaper to pay now than when it's more advanced and more costly.