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Not sure what you mean by back to back but they can be mounted top and bottom of your OTA, one to attach your OTA to the mount and the other to load your guidescope or camera adapter.
You are probably better off mounting your camera on the top of your OTA, gives you a much better chance of balancing everything, on the bottom you always have the chance to drive the camera into the mount, that crunching, grinding sound is not nice.
Cheers
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