Document Detail

Man-in-the-barrel syndrome after thoracoilium fusion.
MedLine Citation:
PMID:  19035749     Owner:  NLM     Status:  MEDLINE    
The authors report a case of man-in-the-barrel (MIB) syndrome occurring after an extensive revision involving thoracoilium instrumentation and fusion for iatrogenic and degenerative scoliosis, progressive kyphosis, and sagittal imbalance. Isolated brachial diplegia is a rare neurological finding often attributed to cerebral ischemia. It has not been previously reported in patients undergoing complex spine surgery. This 70-year-old woman, who had previously undergone T11-S1 fusion for lumbar stenosis and scoliosis, presented with increased difficulty walking and with back pain. She had junctional kyphosis and L5-S1 pseudarthrosis and required revision fusion extending from T-3 to the ilium. In the early postoperative period, she experienced a 30-minute episode of substantial hypotension. She developed delirium and isolated brachial diplegia, consistent with MIB syndrome. Multiple studies were performed to assess the origin of this brachial diplegia. There was no definitive radiological evidence of any causative lesion. After a few days, her cognitive function returned to normal and she regained the ability to move her arms. After several weeks of rehabilitation, she recovered completely. Man-in-the-barrel syndrome is a rare neurological entity. It can result from various mechanisms but most commonly seems to be related to ischemia and is potentially reversible.
Andrei F Joaquim; Catherine C Shaffrey; Charles A Sansur; Christopher I Shaffrey
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of neurosurgery. Spine     Volume:  9     ISSN:  1547-5654     ISO Abbreviation:  -     Publication Date:  2008 Dec 
Date Detail:
Created Date:  2008-11-27     Completed Date:  2009-01-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101223545     Medline TA:  J Neurosurg Spine     Country:  United States    
Other Details:
Languages:  eng     Pagination:  566-9     Citation Subset:  IM    
University of Campinas (UNICAMP), Campinas SP, São Paulo, Brazil.
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MeSH Terms
Paralysis / etiology*
Spinal Curvatures / complications,  radiography,  surgery*
Spinal Fusion / adverse effects*,  methods
Thoracic Vertebrae*

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