Spinal Cord Stimulators: Patient Safety and Adverse Outcomes from Imaging

Abstract

<h3>Research Objectives</h3> A literature review of the current recommendation for SCS compatibility with MR imaging and a review of the Food and Drug Administration (FDA) approved spinal cord stimulation systems were performed. <h3>Design</h3> The literature review was completed using PubMed, the FDA website (www.fda.gov), and the SCS manufacturers' websites. <h3>Setting</h3> N/A. <h3>Participants</h3> N/A. <h3>Interventions</h3> N/A. <h3>Main Outcome Measures</h3> Is the usage of MRI safe in patients with spinal cord stimulators (SCS)? <h3>Results</h3> The current recommendations, composed on the basis of evidence-based medicine, reveal close adherence of an MRI with a 1.5T magnet and a mean total body specific absorption rate (SAR) of 0.9 W/kg or below which can promote patient safety and satisfaction, despite the variability between different SCS manufacturers1. Measurement of safety includes tearing of tissues due to rotational force generated by the magnetic field, acceleration of the device towards the bore of the magnet ("missile effect"), and burns caused by overheating of the device. <h3>Conclusions</h3> Strict adherence to an MRI with a 1.5T magnetic bore core and a SAR of 0.9 W/kg or below can promote patient safety despite the various SCS developed by manufacturers. Providers and technicians should be encouraged to seek specific SAR and Slew Rate and Field Strength conditions found on the manufacturers' website to yield the highest safety index and optimal image quality. <h3>Author(s) Disclosures</h3> None.