Provision of up-to-date magnetic resonance imaging conditionality for current peripheral nerve stimulation and spinal cord stimulation systems in pain management

Pain Med. 2025 Dec 1;26(12):924-929. doi: 10.1093/pm/pnaf076.

Abstract

Background: Magnetic resonance imaging (MRI) safety with implanted neuromodulation devices presents a critical challenge in modern medicine. While spinal cord stimulation (SCS) and peripheral nerve stimulation (PNS) devices are increasingly utilized for pain management, the scattered nature of manufacturer-specific MRI safety information creates substantial challenges for healthcare providers in making informed clinical decisions. Furthermore, despite the public availability of this information, a comprehensive review of the literature reveals no centralized repository of data regarding SCS and PNS.

Objective: To synthesize comprehensive MRI safety data from multiple manufacturers of SCS and PNS devices into a centralized resource for clinicians, thereby streamlining the decision-making process for MRI scanning in patients with implanted neuromodulation devices.

Methods: We collected MRI safety data for devices from 10 major neurostimulation companies (Abbott, Biotronik, Boston Scientific, Curonix, Mainstay, Medtronic, Nalu, Nevro, Saluda, and SPR Therapeutics) through December 2024. Data collection involved direct communication with manufacturers and analysis of technical documentation to extract specific MRI-related parameters.

Results: Full-body MRI safety at 1.5 T is standard across most SCS systems, with select devices permitting 3.0 T imaging. Specific limitations vary by manufacturer, including restrictions on spatial gradient magnetic fields (1000-4000 Gauss/cm), specific absorption rates, and active scan times (15-60 minutes). PNS systems show similar safety patterns.

Conclusions: This manuscript addresses the urgent need for centralized safety information. As device technology continues to evolve, this resource will require ongoing updates to maintain its utility in supporting informed clinical decision making and patient care.

Keywords: MRI safety; neuromodulation; peripheral nerve stimulation; spinal cord stimulation.

MeSH terms

  • Humans
  • Implantable Neurostimulators
  • Magnetic Resonance Imaging* / adverse effects
  • Magnetic Resonance Imaging* / methods
  • Pain Management* / methods
  • Peripheral Nerves
  • Spinal Cord Stimulation* / adverse effects
  • Spinal Cord Stimulation* / instrumentation
  • Spinal Cord Stimulation* / methods
  • Transcutaneous Electric Nerve Stimulation* / instrumentation
  • Transcutaneous Electric Nerve Stimulation* / methods