gms | German Medical Science

Objective: Spinal Cord Stimulation is an evidence based neuromodulatory procedure for the treatment of chronic pain disorders. For a few years MRI compatible systems have been available, they are different however in handling compared to conventional systems. Whereas neurostimulators don't feature any differences in size and surgical handling, MRI compatible leads are longer and have an additional coated surface with a diameter deviation. In this study, we evaluated the complication rates of implanted MRI compatible leads in comparison to data from literature relating to conventional systems.

Method: From 03/2013-03/2014 n=50 patients underwent a test stimulation to assess permanent SCS implantation. MRI compatible octapolar electrodes were inserted in the epidural space percutaneously. The evaluation of the testing was performed using a questionnaire and an interview with the patients. The pulse generator was implanted either abdominal or gluteal.

Results: Indications for SCS trial were neuropathic pain in FBSS in 68% (n=34), CRPS in 6% (n=3/50), intercostal neuralgia and post-herpetic neuralgia in 12% (6/50), posttraumatic neuropathic pain in 8% (n=4/50) and other neuropathies in 6% (n=3/50). After mostly 6 to 7 days trail period 66% (n=33) of the patients received a stimulator implantation for a permanent SCS. Complications were infections at a rate of 8% (n=4/50) and migration of the electrode in 6% (n=3/50). In n=1 case (2%) an epidural haemorrhage led to revision. The overall complication rate relating to lead-implantation was 16%.

Conclusions: According to the literature the complication rates in our series with MRI compatible electrodes did not differ from those with conventional SCS systems. Therefore we support the implantation of these systems in all patients in order to improve the diagnostic value of MRI.