Failure of SCS MR-conditional modes due to high impedance: A review of literature and case series Journal Article

Authors: Jotwani, R.; Abd-Elsayed, A.; Villegas, K.; Shakil, A.; Gulati, A.; Sayed, D.; Lam, C.; Mehta, N.
Article Title: Failure of SCS MR-conditional modes due to high impedance: A review of literature and case series
Abstract: Introduction: Magnetic resonance imaging (MRI) conditional modes are a novel feature for certain Food and Drug Administration (FDA)-approved spinal cord stimulation (SCS) devices. However, there is a paucity of literature around the limitation of MRI-conditional modes (“MRI safe”), specifically in clinical scenarios where urgent MRIs may be needed. One such limitation is load impedance, referring to the circuit’s resistance to the current being generated by the system. High impedance can limit the MRI-conditional mode capability, presenting potential harm to a patient undergoing an MRI or make an MRI unable to be completed. Methods: Three cases were identified, and informed consent was obtained. All information was obtained via retrospective chart review. Results: In this case series of three patients where MRI-conditional SCS systems were unable to be placed in “MRI safe” settings, preventing timely MRI study completion in the setting of high impedance, all three were required to undergo alternative imaging including CT scans, and two patients ultimately had the system explanted and one chose to be re-implanted after completion of scans. Conclusion: This case series highlights the need for further investigation of impedance in SCS systems and potential limitations for future MRI usage. The review of literature of impedance in SCS shows both device- and physiologic-related etiologies for changes in impedance that warrant consideration by the implanting physician. © 2020, The Author(s).
Keywords: adult; clinical article; aged; review; case report; nuclear magnetic resonance imaging; follow up; medical record review; mri; national institutes of health stroke scale; case study; metastatic melanoma; lumbar spine; impedance; radiculopathy; human; male; female; conditional; spinal cord stimulation; electronic health record; scs; transcatheter aortic valve implantation
Journal Title: Pain and Therapy
Volume: 10
Issue: 1
ISSN: 2193-8237
Publisher: Adis International Ltd  
Date Published: 2021-06-01
Start Page: 729
End Page: 737
Language: English
DOI: 10.1007/s40122-020-00219-8
PROVIDER: scopus
PMCID: PMC8119585
PUBMED: 33219927
Notes: Review -- Export Date: 1 July 2021 -- Source: Scopus
Citation Impact
MSK Authors
  1. Amitabh Gulati
    90 Gulati