Advancements in MRI Conditionality of Spinal Cord Stimulation Systems:
A Narrative Review of Recent SCS Systems and MRI Operational Risks
Pravardhan Birthia,b, M.D., Mahesh Pattabiramanb, Ph.D., Harish Kalaivananb, M.B.B.S., Aparajitha Rajkumarb, M.B.B.S., Vittal R Nagarb, MD, Ph.D., Anterpreet Duac, M.D., Mittal S. Prajapatib, M.D., Akshay Agrawald, M.D., Surabhi Chandrae, Ph.D.
a.Grand Island Pain Relief Center (GIPRC), Grand Island, NE
b.Tricity Research Center (TRC), Grand Island, NE
c.Augusta University, Augusta, NE
d.Bryan Health, Grand Island, NE
e.University of Nebraska Kearney, Kearney, NE
Background:
•SCS is key for chronic, treatment-resistant pain.
•MRI can disrupt SCS function — causing heating & malfunctions.
•New SCS devices are safer, but awareness of MRI safety remains crucial.
Objectives:
•Review advances & challenges in MRI-safe SCS devices.
•Highlight key innovations and safety conditions
•Provide practical insights for clinicians..
Methods:
•Analyzed manufacturer manuals, guidelines, literature, and safety data.
•Identified technological advances, adverse events, and clinical implications in MRI use.
•Synthesized findings to present an integrated view of MRI safety in SCS therapy.
Results:
•Notable advancements in MRI-compatible SCS devices include improved lead design, shielding, and programming.
•These innovations have enhanced safety during MRI procedures.
•Reports still note malfunctions such as high lead impedance, heating, and MRI mode errors.
•Some issues have prompted FDA recalls and manufacturer advisories or warnings.
Conclusion:
•MRI-compatible SCS devices are safer than ever.
•Ongoing innovation & vigilance remain essential.
•Future work must close remaining safety gaps.
Acknowledgments:
TCRC (for compiling and communicating manuscript),
GIPRC staff (for compiling data and helping patients) and Rashmi Rikhi (for helping with the poster design)
References:
•Atkinson L, et al. Recommendations for patient selection in spinal cord stimulation. J Clin Neurosci. 2011;18:1295–1302.
•Jabehdar Maralani P, et al. MRI safety and devices: An update and expert consensus. J Magn Reson Imaging. 2020;51:657–674.
•Rubino S, et al. MRI conditionality in patients with spinal cord stimulation devices. Stereotact Funct Neurosurg. 2016;94:254–258.
•Mullins CF, et al. Elevated lead impedances in MR-conditional SCS devices. Pain Pract. 2024;24:270–277.
•Jotwani R, et al. Failure of SCS MR-conditional modes due to high impedance. Pain Ther. 2021;10:729–737.
•FDA Recall Notice. Abbott Medical Recalls Proclaim & Infinity IPGs – MRI Mode Failure. U.S. FDA, 2023.
Hagedorn JM, et al. MRI ineligibility following 10 kHz SCS implantation. Neuromodulation. 2022;25:719–723.
