title: Magnetic resonance imaging of the lumbar spine in a patient with a spinal cord stimulator.
abstract: 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.
  
  
  OBJECTIVE
  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.
  
  
  METHODS
  Case report.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  Single case of a patient with a thoracic SCS having a lumbar MRI study.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Harvard Medical School, Brookline, MA 02445, USA. tsimopou@bidmc.harvard.edu
authors.forename: Thomas T
authors.initials: TT
authors.lastname: Simopoulos
authors.forename: Jatinder S
authors.initials: JS
authors.lastname: Gill
mesh_terms: D059350:Chronic Pain / Q000628:therapy*; D004599:Electric Stimulation Therapy / Q000379:methods*; D049690:History, Ancient; D006801:Humans; D008159:Lumbar Vertebrae / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D013116:Spinal Cord / Q000502:physiology*; D013131:Spine / Q000473:pathology*