Background: The use of magnetic resonance imaging (MRI) is continuously escalating for the
evaluation of patients with persistent pain following lumbar spine surgery (LSS). Spinal cord
stimulation (SCS) therapy is being clinically applied much more commonly for the management of
chronic pain following LSS. There is an increased probability that these 2 incompatible modalities
may be accidentally used in the same patient.
Objectives: The purpose of this case report is to: (1) summarize a case in which a patient with
a thoracic spinal cord stimulator underwent a diagnostic lumbar MRI, (2) describe the 3 magnetic
fields used to generate images and their interactions with SCS devices, and (3) summarize the
present literature.
Study design: Case report.
Setting: University hospital.
Results: Aside from mild heat sensations in the generator/pocket site and very low intensity
shocking sensations in the back while in the MRI scanner, the patient emerged from the study with
no clinically detected adverse events. Subsequent activation of the SCS device would result in a
brief intense shocking sensation. This persisted whenever the device was activated and required
Implantable Pulse Generator (IPG) replacement. Electrical analysis revealed that some of the output
circuitry switches, which regulate IPG stimulation and capacitor charge balancing, were damaged,
most likely by MRI radiofrequency injected current.
Limitations: Single case of a patient with a thoracic SCS having a lumbar MRI study.
Conclusion: This case demonstrates the lack of compatibility of lumbar MRI and the Precision
SCS system as well as one of the possible patient adverse events that can occur when patients are
exposed to MRI outside of the approved device labeling.
Key words: Spinal cord stimulation devices, magnetic resonance imaging
Magnetic Resonance Imaging of the Lumbar
Spine in a Patient with a Spinal Cord Stimulator
