Ana Paula was born a conjoined twin, with not just three legs but three kidneys and potential reproductive issues.

With three legs all to herself, the 22-month-old toddler from Panama will next month undergo a major surgery at Shriners Hospitals for Children Los Angeles to remove the two that don’t work.

Her sister did not survive the procedure that separated them when they were roughly three weeks old. Their medical condition is so rare, in fact, that only a dozen survivable cases are reported each year, reports KTLA.

Ana is to have her middle leg removed; as for her right leg, the knee and foot aren’t functional, so doctors expect it to be amputated at the knee or higher.

“I think she’ll be very functional as a walker, at the very least with crutches or with the arm crutches or something similar,” one of the surgeons tells CBS. Still, even with a prosthetic she’s not expected to ever walk normally, and the doctors say she suffers other acute medical conditions as well.

Her treatment is being paid for by the nonprofit Children of War Foundation and two of the Shriners Hospitals for Children in California.

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