Theoretical evaluation of peripheral nerve stimulation during MRI with an implanted spinal fusion stimulator.
This study examines the requirements for nerve excitation near a spinal fusion implant during magnetic resonance imaging. The implant is the Spinal Fusion SpF device manufactured by Electro Biology Inc. The electric field induced within the biological medium was calculated using a three-dimensional finite difference model (described in a separate paper by Beuchler et al. from the University of Utah). Magnetic thresholds were obtained for excitation of myelinated nerve fibers that are near the implant. Minimum (rheobase) thresholds were determined for long duration dB/dt pulses, as well as strength-duration time constants (from which thresholds at other durations could be determined) for various geometries between the implant and a myelinated nerve fiber. The lowest thresholds occur when a large (20-microm diameter) fiber is situated near the bare tip of a wire from the implant, and a long duration (2 ms) stimulus is provided for which dB/dt is constant and monophasic. Magnetic thresholds for shorter durations of dB/dt are higher in accordance with a strength-duration law. In a magnetic field having a time derivative of 10 T/s that is uniform over the torso, nerve excitation is possible under worst-case conditions only for nerve fibers that are within 0.14 mm of the bare wire tip of the implant. With 20 T/s, excitation is possible only within 1 mm of the wire tip.
Reilly
J P
JP
The Johns Hopkins University, Applied Physics Laboratory, Silver Spring, MD 20904, USA.
Diamant
A M
AM
D000818:Animals; D004558:Electric Stimulation; D004567:Electrodes, Implanted; D005069:Evaluation Studies as Topic; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000295:instrumentation / Q000379:methods; D008962:Models, Theoretical; D010525:Peripheral Nerves / Q000473:pathology / Q000503:physiopathology*; D010523:Peripheral Nervous System Diseases / Q000503:physiopathology* / Q000628:therapy; D013123:Spinal Fusion / Q000295:instrumentation / Q000379:methods*